Doctor Name: | GRACE L. GRANT |
NPI Number: | 1083040703 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | XL4025 |
Business Practice Address: | 66 Sherman St Island Falls, ME - 047474415 |
Business Phone Number: | 2074632034 |
Business Fax Number: | |
Mailing Address: | Po Box 42, ISLAND FALLS |
State: | ME |
Postal Code: | 047470042 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 09/26/2013 |
NPI Last Update Date: | 09/26/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | XL4025 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | ME |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |