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NPI 1427822899

NPI 1427822899 : REBECCA GRADY : GREENVILLE, NC

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General NPI Number Information
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    NPI Number           |    1427822899
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    Entity Type          |    Individual 
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    Provider Name        |    REBECCA GRADY
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    11/07/2023
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    Last Update Date     |    02/17/2026
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Provider Practice Location Address
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    Address Line         |    700B CROMWELL DR 
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    City                 |    GREENVILLE
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    State                |    NC
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    Zip                  |    27858-5852
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    Country              |    US
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    Telephone            |    855-223-7123
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    Fax                  |    619-374-7134
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Provider Business Mailing Address
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    Address Line         |    PO BOX 740780 
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    City                 |    ATLANTA
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    State                |    GA
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    Zip                  |    30374-0780
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    Country              |    US
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    Telephone            |    855-223-7123
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    Fax                  |    619-374-7134
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    106S00000X
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    Taxonomy Name        |    Behavior Technician
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    License Number       |    RBT-23-295351
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    License Number State |    NC
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