Individual
MR. SHANE OWEN GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
91 ELM ST APT 312E, MANCHESTER, CT 06040-8632
(860) 969-7147
Mailing address
91 ELM ST APT 312E, MANCHESTER, CT 06040-8632
(860) 969-7147
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
05/12/2016
Last updated
05/12/2016
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