Individual
GRACI MADDOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3729 KLINDT DR, THE DALLES, OR 97058-3566
(541) 298-2101
(541) 298-7996
Mailing address
3729 KLINDT DR, THE DALLES, OR 97058-3566
(541) 298-2101
(541) 298-7996
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/09/2024
Last updated
08/09/2024
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