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Individual
ROBERTA MARINA GRANT
Active
Individual
ROBERTA MARINA GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
60836397
WA
225700000X
Massage Therapist
10856
OR
225700000X
Massage Therapist
MA 00020199
WA
Other
Enumeration date
05/19/2010
Last updated
10/01/2020
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