Individual
GRACIE HARRISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
112 S COMMERCE ST, GENEVA, AL 36340-2211
(334) 618-3302
Mailing address
112 S COMMERCE ST, GENEVA, AL 36340-2211
(334) 618-3302
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-23-8197-650916
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RBT-23-8197-650916
RBT-23-8197-650916
AL
Enumeration date
03/27/2024
Last updated
03/27/2024
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