Individual
NICHOLAS GRACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2000 W BRIGGSMORE AVE STE I, MODESTO, CA 95350-3839
(209) 526-1476
Mailing address
2000 W BRIGGSMORE AVE STE I, MODESTO, CA 95350-3839
(209) 526-1476
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
17828
CA
Other
Enumeration date
04/03/2023
Last updated
10/24/2024
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