Individual
KENNEDY GRACE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
525 N TRYON ST, CHARLOTTE, NC 28202-0202
(855) 832-6727
Mailing address
4710 TOPSAIL LN APT 206, WINSTON SALEM, NC 27107-7204
(336) 817-7049
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
—
—
Other
Enumeration date
12/18/2024
Last updated
12/18/2024
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