Individual
REBECCA LANE GRATZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPSS
Contact information
Practice address
501 BAXTER AVE STE 125, LOUISVILLE, KY 40204-1103
(502) 233-3290
Mailing address
1039 CHEROKEE RD APT 2A, LOUISVILLE, KY 40204-1278
(502) 224-1815
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
11/05/2021
Last updated
11/05/2021
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