Organization · NPI-2

Thomas Grace Psy.D.

Clinic/Center, Mental Health (Including Community Mental Health Center) · Fair Lawn, NJ

NPI number1942574330
StatusActive
Last updated in NPPESMar 1, 2012

Details

NPI
1942574330
Entity type
Organization (NPI-2)
Legal business name
Thomas Grace Psy.D.
Organization subpart
No
Enumeration date
Mar 1, 2012
Last updated
Mar 1, 2012

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center)35s100487500NJYes

Practice location

14-25 Plaza Rd
Suite N-2-4
Fair Lawn, NJ 07410-3546

Phone 201-207-2199

Mailing address

14-25 Plaza Rd
Suite N-2-4
Fair Lawn, NJ 07410-3546

Phone 201-207-2199

Authorized official

Thomas Grace
Psychologist
2012072199

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