Individual
LETANYA EDJUAND HARGRAVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11773 BRAY BIRCH LN, FORT WORTH, TX 76244-6780
(817) 744-6128
Mailing address
350 KELLER PKWY, KELLER, TX 76248-2249
(817) 744-6128
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
32775
TX
Other
Enumeration date
12/10/2021
Last updated
12/10/2021
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