SHANE OWEN GRANT

MANCHESTER, CT
NPI1043666779
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YM0800X Counselor, Mental Health
Enumeration Date2016-05-12
Last Update Date2016-05-12
Business Address
Mr. SHANE OWEN GRANT
91 ELM ST APT 312E
MANCHESTER, CT 06040-8632
Phone number: 860-969-7147
Mailing Address
Mr. SHANE OWEN GRANT
91 ELM ST APT 312E
MANCHESTER, CT 06040-8632
Phone number: 860-969-7147
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