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1639684285
GRANT GERARD
FORT WAYNE, IN
NPI
1639684285
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: IN 34007989A)
Enumeration Date
2017-12-05
Last Update Date
2021-08-06
Business Address
GRANT GERARD LCSW, LAC
3909 NEW VISION DR
FORT WAYNE, IN 46845
Phone number: 260-373-8000
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Mailing Address
GRANT GERARD LCSW, LAC
11109 PARKVIEW PLAZA DR # 117
FORT WAYNE, IN 46845-1701
Phone number:
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