Individual
JANICE EILEEN GRADY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW, LPC, MA, LLP
Contact information
Practice address
243 68TH ST SE, GRAND RAPIDS, MI 49548-6924
(616) 222-5180
Mailing address
300 68TH ST SE, GRAND RAPIDS, MI 49548-6927
(616) 455-5000
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
6401001613
MI
103T00000X
Psychologist
Primary
6301005392
MI
104100000X
Social Worker
6801018087
MI
Other
Enumeration date
01/30/2008
Last updated
01/30/2008
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