Individual
TRACEY A. GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
1046 E WESLEYAN DR, TEMPE, AZ 85282-3819
(817) 905-6467
Mailing address
1046 E WESLEYAN DR, TEMPE, AZ 85282-3819
(817) 905-6467
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1050263
AZ
133V00000X
Registered Dietitian
DI60260239
WA
Other
Enumeration date
11/21/2011
Last updated
09/30/2019
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