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General NPI Number Information
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NPI Number | 1215890090
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Entity Type | Organization
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Legal Business Name | GRIT AND GRACE WELLNESS THERAPY LLC
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Dates
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Enumeration Date | 12/08/2025
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 531 COMMERCIAL ST STE 700
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City | WATERLOO
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State | IA
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Zip | 50701-5443
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Country | US
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Telephone | 319-486-1923
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Fax |
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Provider Business Mailing Address
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Address Line | 8102 STREETER RD
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City | CEDAR FALLS
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State | IA
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Zip | 50613-9740
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Country | US
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Telephone | 319-290-6001
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Fax |
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Authorized Official
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Title or Position | OWNER/MENTAL HEALTH THERAPIST
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Name | ALYSSA M PROHASKI
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Credential | LISW
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Telephone | 319-290-6001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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