Individual
BRAYDEN GRUENEWALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2425 E SOUTHLAKE BLVD, SOUTHLAKE, TX 76092-6674
(817) 442-0222
Mailing address
2425 E SOUTHLAKE BLVD, SOUTHLAKE, TX 76092-6674
(817) 442-0222
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
20131500
TX
Other
Enumeration date
08/20/2020
Last updated
08/20/2020
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