Provider Demographics
NPI:1790883817
Name:WEYRAUCH, GRACE ELAINE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:GRACE
Middle Name:ELAINE
Last Name:WEYRAUCH
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:14350 N FRANK LLOYD WRIGHT BLVD
Mailing Address - Street 2:SUITE 9
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-8843
Mailing Address - Country:US
Mailing Address - Phone:480-477-7660
Mailing Address - Fax:480-477-7662
Practice Address - Street 1:14350 N FRANK LLOYD WRIGHT BLVD
Practice Address - Street 2:SUITE 9
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-8843
Practice Address - Country:US
Practice Address - Phone:480-477-7660
Practice Address - Fax:480-477-7662
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC10311101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional