Gracie Northrup

NPI #1154151116 in Ardmore, Oklahoma

Provider Information

NPI Number: 1154151116
Entity Type: Individual
Name: Gracie Northrup
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Aug 5, 2024
Last Updated: Aug 5, 2024

Practice Location

Address: 1301 KIOWA ST
City: Ardmore
State: Oklahoma
ZIP Code: 73401-2280
Phone: (580) 850-1160

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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