Individual
DR. BRIAN WILLIAM GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH. D.
Contact information
Practice address
921 E 86TH ST, INDIANAPOLIS, IN 46240-1859
(317) 590-2727
(317) 669-2096
Mailing address
9507 CADBURY CIR, INDIANAPOLIS, IN 46260-1000
(317) 590-2727
(317) 669-2096
Taxonomy
Speciality
Code
Description
License number
State
103TH0100X
Health Service Psychologist
Primary
20090164A
IN
106H00000X
Marriage & Family Therapist
35000590A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200456500A
—
IN
Enumeration date
12/15/2006
Last updated
08/17/2009
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