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General NPI Number Information
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NPI Number | 1487860805
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Entity Type | Individual
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Provider Name | BARBARA ROSE GRACE PH.D.
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Gender | Female
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Dates
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Enumeration Date | 05/15/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | THE GRACE CENTER, PC 118 BARRINGTON COMMONS, SUITE 227
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City | BARRINGTON
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State | IL
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Zip | 60010
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Country | US
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Telephone | 847-382-3232
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Fax |
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Provider Business Mailing Address
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Address Line | 444 OLD BARN RD APT C
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City | LAKE BARRINGTON
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State | IL
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Zip | 60010-6207
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Country | US
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Telephone | 847-381-1710
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 72-002799
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License Number State | IL
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