Provider Demographics
NPI:1740174218
Name:TREUTEL, GRACE (MFTA)
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:
Last Name:TREUTEL
Suffix:
Gender:F
Credentials:MFTA
Other - Prefix:
Other - First Name:GRACE
Other - Middle Name:
Other - Last Name:PORTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:GRACE PORTER
Mailing Address - Street 1:3205 TERESA DR
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35217-1043
Mailing Address - Country:US
Mailing Address - Phone:251-472-7555
Mailing Address - Fax:
Practice Address - Street 1:1211 27TH PL S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35205-1806
Practice Address - Country:US
Practice Address - Phone:251-472-7555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-07
Last Update Date:2025-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALA123106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist