Doctor Name: | MS. GLORIA FAY GRANT |
NPI Number: | 1194089862 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | SW1208 |
Business Practice Address: | 5393 Painted Pony Ave Melrose, FL - 326668863 |
Business Phone Number: | 3524736613 |
Business Fax Number: | 3524731020 |
Mailing Address: | 5393 Painted Pony Ave, MELROSE |
State: | FL |
Postal Code: | 326668863 |
Phone Number: | 3524736613 |
Fax Number: | 3524731020 |
NPI Enumeration Date: | 06/27/2012 |
NPI Last Update Date: | 06/27/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | SW1208 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |