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Individual

JANIE GRANT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OT

Contact information

Practice address
500 TAMAL PLZ STE 525&527, CORTE MADERA, CA 94925-1151
(415) 531-3027
(941) 655-8839
Mailing address
301 NORTH AVE UNIT 102, SAN RAFAEL, CA 94903-5557
(818) 640-3359

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
19097
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
19097
OCCUPATIONAL THERAPIST LICENSE
CA
Enumeration date
06/28/2019
Last updated
06/28/2019
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