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General NPI Number Information
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NPI Number | 1689556508
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Entity Type | Individual
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Provider Name | GRACE ONDARA
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Gender | Female
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Dates
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Enumeration Date | 07/22/2025
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Last Update Date | 07/22/2025
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Provider Practice Location Address
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Address Line | 1911 NICOLLET AVE # 230
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City | MINNEAPOLIS
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State | MN
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Zip | 55403-3747
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Country | US
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Telephone | 952-715-7733
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Fax |
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Provider Business Mailing Address
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Address Line | 500 E GRANT ST APT 310
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City | MINNEAPOLIS
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State | MN
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Zip | 55404-1427
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Country | US
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Telephone | 952-715-7733
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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 | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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