Individual
GRACE WELLIVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
2601 WILLARD RD STE 104, HENRICO, VA 23294-3638
(540) 327-3321
Mailing address
2505 STUART AVE APT B, RICHMOND, VA 23220-3357
(540) 327-3321
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/09/2021
Last updated
04/09/2021
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