Individual
GRACIE ANN MATTHEWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
585 WORTHAM ST, KENAI, AK 99611-8518
(907) 953-6482
Mailing address
585 WORTHAM ST, KENAI, AK 99611-8518
(907) 953-6482
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
11/17/2020
Last updated
11/17/2020
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