Individual
NIA JOWAN GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
4530 MONTAIR AVE APT 15, LONG BEACH, CA 90808-1229
(678) 488-7539
Mailing address
PO BOX 8053, INGLEWOOD, CA 90308-8053
(678) 488-7539
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
9213
NC
101YP2500X
Professional Counselor
Primary
17495
AZ
101YP2500X
Professional Counselor
LPC005539
GA
Other
Enumeration date
03/23/2010
Last updated
10/29/2025
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