Individual
GRACE GREENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1001 COLLEGE AVE STE A, JACKSON, AL 36545-2402
(251) 744-5124
Mailing address
4623 MELISSA WAY, VESTAVIA, AL 35243-5343
(334) 419-4771
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
5193
AL
Other
Enumeration date
11/07/2023
Last updated
11/07/2023
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