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Individual
NICOLE S GRANT
Active
Individual
NICOLE S GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
070547
NY
1041C0700X
Clinical Social Worker
Primary
070547
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05029089
—
NY
Enumeration date
12/21/2017
Last updated
11/18/2025
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