Individual
RENEE M. GRADY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
1 BENTON CIR, LONOKE, AR 72086-3624
(501) 676-0038
Mailing address
1 BENTON CIR, LONOKE, AR 72086-3624
(501) 676-0038
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP# 679
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
125535721
—
AR
Enumeration date
05/23/2008
Last updated
12/10/2015
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