Provider Demographics
NPI:1063262442
Name:MOSIER, GRACE
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:
Last Name:MOSIER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:911 MASSACHUSETTS ST APT C8
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66044-2887
Mailing Address - Country:US
Mailing Address - Phone:785-817-8401
Mailing Address - Fax:
Practice Address - Street 1:3205 CLINTON PARKWAY CT
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66047-2627
Practice Address - Country:US
Practice Address - Phone:785-330-5688
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-26
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional