Individual
EMMA GRACE BRANCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
426 W LAWRENCE HARRIS HWY # 52, SLOCOMB, AL 36375-5352
(334) 618-3302
Mailing address
426 W LAWRENCE HARRIS HWY # 52, SLOCOMB, AL 36375-5352
(334) 618-3302
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25-484706
25-484706
AL
Enumeration date
11/04/2025
Last updated
11/04/2025
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