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1669834362
STACY GRANT
PHILADELPHIA, PA
NPI
1669834362
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
252Y00000X Early Intervention Provider Agency
(Licence: PA OC012558)
Enumeration Date
2016-03-22
Last Update Date
2016-10-17
Business Address
-- STACY GRANT
415 S 42ND ST APT 4
PHILADELPHIA, PA 19104-4094
Phone number: 570-977-0646
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Mailing Address
-- STACY GRANT
415 S 42ND ST APT 4
PHILADELPHIA, PA 19104-4094
Phone number: 570-977-0646
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