Grace, Tanya R

Grace, Tanya R is an individual health care provider with primary practice located at 2655 Ridgeway Ave Suite 420, Rochester NY 14626-4296. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical Neuropsychologist, which is considered as her primary health care specialty. Grace, Tanya R can be contacted via phone (585) 723-7972.

Contact Information

Primary practice address
2655 Ridgeway Ave Suite 420 Rochester NY 14626-4296
Phone: (585) 723-7972
Fax: (585) 368-3119
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical Neuropsychologist 103G00000X 020255 New York

Profile Details

NPI number 1972931772
LBN Legal business name Grace, Tanya R
Credentials PSYD
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 15th, 2013
Last updated Oct 18th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1972931772 NPPES
New York Other P01662182 MEDICARE RR

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