Healthcare Provider Details

I. General information

NPI: 1174434989
Provider Name (Legal Business Name): GRAYCE LYN WORKMAN RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2031 VILLAGE VIEW CIR APT 107
BELMONT NC
28012-3369
US

IV. Provider business mailing address

2031 VILLAGE VIEW CIR APT 107
BELMONT NC
28012-3369
US

V. Phone/Fax

Practice location:
  • Phone: 803-371-3696
  • Fax:
Mailing address:
  • Phone: 803-371-3696
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-26-2848338
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: