Individual
SHAWNTA GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1253 DICKSON AVE STE 105, HANAHAN, SC 29410-2853
(843) 901-1242
Mailing address
1253 DICKSON AVE STE 105, HANAHAN, SC 29410-2853
(843) 901-1242
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
IHCP-1756
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
IHCP-1756
DHEC HOME CARE LICENSE NUMBER
SC
Enumeration date
11/29/2022
Last updated
11/29/2022
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