Individual
MRS. GRACE MARIE WIGHTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MED
Contact information
Practice address
2900 E 29TH ST, BRYAN, TX 77802-2622
(979) 776-8440
Mailing address
950 TOWN LAKE DR APT 7302, COLLEGE STATION, TX 77845-2277
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
06/24/2025
Last updated
06/24/2025
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