| NPI | 1902148687 |
|---|---|
| Former Name | GENEVIEVE MARIE GRANT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral |
| Enumeration Date | 2013-03-20 |
| Last Update Date | 2013-03-20 |