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NPI Code Detail

MEDICARE: MS. GRAYCE LENORE GUSMANO MMFT, LPC

MEDICARE: MS. GRAYCE LENORE GUSMANO MMFT, LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor10755AZ

General Provider Information

NPI Number : 1316087893
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. GRAYCE LENORE GUSMANO MMFT, LPC
Provider Business Mailing Address
First Line : 7530 E ANGUS DR
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85251-6410
Country : US
Telephone Number : 480-947-5739
Fax Number : 480-946-7795
Provider Business Practice Location Address
First Line : 7530 E ANGUS DR
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85251-6410
Country : US
Telephone Number : 480-947-5739
Fax Number : 480-946-7795
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/07/2007
Last Update Date : 07/08/2007

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