Individual
GRACE GREENLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
418 W MOUNTAIN ST STE B, KERNERSVILLE, NC 27284-2534
(704) 612-6537
Mailing address
2002 STONEYCREEK DR APT M, HIGH POINT, NC 27265-3855
(336) 301-2814
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/21/2020
Last updated
08/21/2020
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