Individual
GRACE SHADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
1250 W BROADWAY AVE, MINNEAPOLIS, MN 55411-2533
(605) 951-4948
Mailing address
1355 CARLING DR APT 240, SAINT PAUL, MN 55108-5231
(605) 951-4948
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
04/28/2025
Last updated
04/28/2025
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