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Individual

MS. GRACE MARIE STUART

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
3522 SUNSET BLVD, HOUSTON, TX 77005-2134
(832) 622-5518
(713) 473-0070
Mailing address
PO BOX 7312, HOUSTON, TX 77248-7312
(832) 622-5518
(713) 473-0070

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
S00573
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10011672
AMERIGROUP
05
107678801
TX
01
275652000
MAGELLAN
Enumeration date
08/04/2006
Last updated
08/03/2009
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