Individual
BETTY GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10010 KENNERLY RD, SAINT LOUIS, MO 63128-2106
(314) 525-4412
(314) 525-4420
Mailing address
10010 KENNERLY RD, SAINT LOUIS, MO 63128-2106
(314) 525-4412
(314) 525-4420
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
003322
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003322
CLINICAL SOCIAL WORKER
MO
Enumeration date
03/04/2014
Last updated
01/11/2022
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