Individual
KELLY GRACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3501 SHEPPARD ACCESS RD, WICHITA FALLS, TX 76306-4235
(940) 228-5297
Mailing address
3501 SHEPPARD ACCESS RD, WICHITA FALLS, TX 76306-4235
(940) 228-5297
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
0-15-6568
TX
Other
Enumeration date
07/27/2015
Last updated
07/27/2015
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