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Individual

SHANNON GRANT-HAILEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RD, CDN

Contact information

Practice address
111 E 210TH ST, BRONX, NY 10467-2401
(718) 920-8468
(718) 654-7648
Mailing address
3444 KOSSUTH AVE, BRONX, NY 10467-2410
(718) 920-8468
(718) 654-7648

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
NY

Other

Enumeration date
12/23/2019
Last updated
01/13/2020
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