Individual
BETHANY JAYNE GRACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS CCC-SLP
Contact information
Practice address
626 PARK AVE, CRANSTON, RI 02910-2154
(401) 270-9991
Mailing address
82 IVY ST APT 2, PROVIDENCE, RI 02906-2557
(401) 714-5548
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP01649
RI
Other
Enumeration date
03/05/2022
Last updated
03/05/2022
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