Individual
COURTNEY GRAGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2 HORNET DR, FULTON, MO 65251-2732
(573) 590-8000
Mailing address
2 HORNET DR, FULTON, MO 65251-2732
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2012003891
MO
Other
Enumeration date
10/02/2012
Last updated
10/02/2012
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