Individual
MRS. GRACE LEE KAVANAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CGC
Contact information
Practice address
838 BANCROFT WAY, BERKELEY, CA 94710-2236
(510) 333-5622
Mailing address
838 BANCROFT WAY, BERKELEY, CA 94710-2236
(510) 333-5622
Taxonomy
Speciality
Code
Description
License number
State
170300000X
Genetic Counselor (M.S.)
Primary
GC0000000413
TN
Other
Enumeration date
08/02/2021
Last updated
08/02/2021
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