| NPI | 1053894618 |
|---|---|
| Other Name | GRACE OGHALE GORDON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251E00000X Home Health |
| Additional Taxonomies | 106S00000X Behavior Technician |
| 172V00000X Community Health Worker | |
| 174H00000X Health Educator | |
| 175T00000X Peer Specialist | |
| 251S00000X | |
| Enumeration Date | 2018-09-10 |
| Last Update Date | 2018-09-10 |