Individual
MARCIA K GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW LMFT
Contact information
Practice address
415 E COOK RD, SUITE 100, FORT WAYNE, IN 46825-3636
(260) 489-6030
(260) 489-5536
Mailing address
415 E COOK RD, SUITE 100, FORT WAYNE, IN 46825-3636
(260) 489-6030
(260) 489-5536
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
34001472A
IN
Other
Enumeration date
12/08/2006
Last updated
11/02/2015
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