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Individual
GRACE BARDWELL FUGATE
Active
Individual
GRACE BARDWELL FUGATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
RBT-21-168696
KS
235Z00000X
Speech-Language Pathologist
Primary
123281
TX
247000000X
Health Information Technician
—
—
Other
Enumeration date
05/19/2021
Last updated
10/22/2025
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