Individual
SAMANTHA LORRAINE GRADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
150 N MAIN ST APT 706, WICHITA, KS 67202-5506
(212) 481-4040
Mailing address
150 N MAIN ST APT 706, WICHITA, KS 67202-5506
(954) 825-3054
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
KS
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
03/30/2026
Last updated
06/18/2026
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