Provider Demographics
NPI:1336674712
Name:HAWLEY, GRACE KATHERINE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:GRACE
Middle Name:KATHERINE
Last Name:HAWLEY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 SPENCER RD STE 101
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63376-2574
Mailing Address - Country:US
Mailing Address - Phone:503-962-0052
Mailing Address - Fax:
Practice Address - Street 1:255 SPENCER RD STE 101
Practice Address - Street 2:
Practice Address - City:SAINT PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376-2574
Practice Address - Country:US
Practice Address - Phone:503-962-0052
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-24
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
MO2023020843103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health