NPI | 1760746952 |
---|---|
Former Name | STEPHANIE E GRANT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: ME MF3166) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA MFC35186) |
Enumeration Date | 2012-07-02 |
Last Update Date | 2012-07-02 |