Healthcare Provider Details

I. General information

NPI: 1851252407
Provider Name (Legal Business Name): GRACE COMPTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/22/2025
Last Update Date: 09/20/2026
Certification Date: 09/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 SUPERIOR DR
SPRING LAKE NC
28390-3190
US

IV. Provider business mailing address

6720 WATER TRAIL DR APT 307
FAYETTEVILLE NC
28311-7148
US

V. Phone/Fax

Practice location:
  • Phone: 910-500-7880
  • Fax: 919-869-1685
Mailing address:
  • Phone: 251-422-8261
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: