Individual
JENNIFER K GRAGG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MOTR/L
Contact information
Practice address
1501 SAN PEDRO DR SE, ALBUQUERQUE, NM 87108-5153
(505) 265-1711
Mailing address
7 PRAIRIE HAWK DR, LOS LUNAS, NM 87031-7177
(575) 915-6154
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT4630
NM
Other
Enumeration date
03/07/2022
Last updated
03/07/2022
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