Doctor Name: | MS. REGINA GRANT |
NPI Number: | 1013346394 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | 8456 |
Business Practice Address: | 31 Abbotsford Ave West Hartford, CT - 061102201 |
Business Phone Number: | 8609515456 |
Business Fax Number: | |
Mailing Address: | 31 Abbotsford Ave, WEST HARTFORD |
State: | CT |
Postal Code: | 061102201 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 11/06/2013 |
NPI Last Update Date: | 11/06/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 8456 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |