Individual
GRACE GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
308 GREENVILLE BLVD SE STE B1, GREENVILLE, NC 27858-5758
(252) 341-4192
Mailing address
308 GREENVILLE BLVD SE STE B1, GREENVILLE, NC 27858-5758
(252) 341-4192
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
11/29/2021
Last updated
11/29/2021
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