Provider Demographics
NPI:1407279466
Name:GRACE, JAMIE ELIZABETH
Entity Type:Individual
Prefix:MISS
First Name:JAMIE
Middle Name:ELIZABETH
Last Name:GRACE
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:JAMIE
Other - Middle Name:ELIZABETH
Other - Last Name:HERRING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1500 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:TURTLE CREEK
Mailing Address - State:PA
Mailing Address - Zip Code:15145-1659
Mailing Address - Country:US
Mailing Address - Phone:412-378-8571
Mailing Address - Fax:
Practice Address - Street 1:1500 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:TURTLE CREEK
Practice Address - State:PA
Practice Address - Zip Code:15145-1659
Practice Address - Country:US
Practice Address - Phone:412-378-8571
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-28
Last Update Date:2014-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor