Individual
GRACE NORTHOVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
703 OH-28, MILFORD, OH 45150
(513) 587-8899
Mailing address
131 PEBBLEBROOKE RUN, CANTON, GA 30115-5521
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-23-287546
GA
Other
Enumeration date
05/07/2024
Last updated
05/07/2024
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