Provider Demographics
NPI:1275936338
Name:BYERLEE, GRACE (MS)
Entity Type:Individual
Prefix:
First Name:GRACE
Middle Name:
Last Name:BYERLEE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:193 GOVERNORS PARK RD
Mailing Address - Street 2:
Mailing Address - City:BELLEFONTE
Mailing Address - State:PA
Mailing Address - Zip Code:16823-2532
Mailing Address - Country:US
Mailing Address - Phone:570-660-4434
Mailing Address - Fax:
Practice Address - Street 1:190 MATCH FACTORY PL
Practice Address - Street 2:
Practice Address - City:BELLEFONTE
Practice Address - State:PA
Practice Address - Zip Code:16823-1367
Practice Address - Country:US
Practice Address - Phone:814-353-1487
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-03
Last Update Date:2014-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health