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General NPI Number Information
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NPI Number | 1912445230
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Entity Type | Individual
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Provider Name | GRACE AFRAKOMAH GYIMAH LMSW
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Gender | Female
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Dates
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Enumeration Date | 02/07/2017
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Last Update Date | 02/07/2017
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Provider Practice Location Address
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Address Line | 1300 W UNIVERSITY AVE
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City | FLAGSTAFF
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State | AZ
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Zip | 86001-7214
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Country | US
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Telephone | 928-221-4330
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Fax |
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Provider Business Mailing Address
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Address Line | 5404 E CORTLAND BLVD APT 166
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City | FLAGSTAFF
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State | AZ
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Zip | 86004-2516
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Country | US
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Telephone | 928-221-4330
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | LMSW-16531
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License Number State | AZ
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