Individual
GREYSON RAINE WALLRATH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT-24-365425
Contact information
Practice address
205 AYERS CIR, SUMMERVILLE, SC 29485-3303
(843) 460-2605
Mailing address
205 AYERS CIR, SUMMERVILLE, SC 29485-3303
(843) 460-2605
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-24-365425
SC
Other
Enumeration date
07/29/2024
Last updated
07/15/2026
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