Provider Demographics
NPI:1356144661
Name:LAGRANGE, GRACE ELIZABETH
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:ELIZABETH
Last Name:LAGRANGE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:GRACIE
Other - Middle Name:ELIZABETH
Other - Last Name:LAGRANGE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:700 SW 107TH AVE APT 1853
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-1302
Mailing Address - Country:US
Mailing Address - Phone:207-232-4046
Mailing Address - Fax:
Practice Address - Street 1:140 NW 59TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33127-1218
Practice Address - Country:US
Practice Address - Phone:305-759-8888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-31
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker