Individual
KATHRYN GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2219 N KENMORE AVE, CHICAGO, IL 60614-3504
(773) 325-4241
Mailing address
2219 N KENMORE AVE, CHICAGO, IL 60614-3504
(773) 325-4241
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071-005996
IL
Other
Enumeration date
03/17/2021
Last updated
03/17/2021
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