SHAQUILLE GRANT

AMES, IA
NPI1104354984
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2017-05-24
Last Update Date2018-06-16
Business Address
SHAQUILLE GRANT
804 KELLOGG AVE
AMES, IA 50010-6234
Phone number: 515-233-4931
Mailing Address
SHAQUILLE GRANT
420 KELLOGG AVE
AMES, IA 50010-6226
Phone number: 515-233-3141
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