Individual
GRACEN ELIZABETH CARDWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3360 JAECKLE DR STE 120, WILMINGTON, NC 28403-2843
(910) 660-8200
Mailing address
3360 JAECKLE DR STE 120, WILMINGTON, NC 28403-2843
(910) 660-8200
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-24-336831
NC
Other
Enumeration date
10/29/2024
Last updated
10/29/2024
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