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Individual
MR. PHILLIP RYAN GRANT
Active
Individual
MR. PHILLIP RYAN GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
SW131675
PA
1041C0700X
Clinical Social Worker
Primary
CW021613
PA
Other
Enumeration date
12/17/2018
Last updated
05/06/2021
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