Individual
GRACE KANG SONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
505 SAN MARIN DR STE 100B, NOVATO, CA 94945-1309
(336) 645-6733
Mailing address
1822 RONIE WAY, SAN JOSE, CA 95124-3630
(669) 262-9648
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
—
—
Other
Enumeration date
06/14/2023
Last updated
06/14/2023
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