Individual
GRACE PHELPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LLC
Contact information
Practice address
7895 CURRIER DR, PORTAGE, MI 49002-4314
(269) 910-7327
Mailing address
300 68TH ST SE, GRAND RAPIDS, MI 49548-6927
(616) 455-5000
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6451024035
MI
101Y00000X
Counselor
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
03/15/2022
Last updated
12/05/2024
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