Provider Demographics
NPI:1316087893
Name:GUSMANO, GRAYCE LENORE (MMFT, LPC)
Entity type:Individual
Prefix:MS
First Name:GRAYCE
Middle Name:LENORE
Last Name:GUSMANO
Suffix:
Gender:F
Credentials:MMFT, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7530 E ANGUS DR
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-6410
Mailing Address - Country:US
Mailing Address - Phone:480-947-5739
Mailing Address - Fax:480-946-7795
Practice Address - Street 1:7530 E ANGUS DR
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-6410
Practice Address - Country:US
Practice Address - Phone:480-947-5739
Practice Address - Fax:480-946-7795
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ10755101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional