Healthcare Provider Details

I. General information

NPI: 1700723467
Provider Name (Legal Business Name): GRACE BRINDLE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

728 W KAYE AVE
MARQUETTE MI
49855-2729
US

IV. Provider business mailing address

433 SILVER CREEK RD
MARQUETTE MI
49855-9341
US

V. Phone/Fax

Practice location:
  • Phone: 765-376-4344
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6451025032
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: