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1124703103
JACKQUELIN MARIE GRANT
BROOKLYN, NY
NPI
1124703103
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
103TC0700X Psychologist, Clinical
(Licence: NY 020226)
Enumeration Date
2023-06-19
Last Update Date
2023-06-19
Business Address
JACKQUELIN MARIE GRANT LP-MHC
26 COURT ST STE 409
BROOKLYN, NY 11242-1134
Phone number: 212-405-2685
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Mailing Address
JACKQUELIN MARIE GRANT LP-MHC
510 W 52ND ST APT 19F
NEW YORK, NY 10019-5298
Phone number: 646-284-6394
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