Individual
FELENE GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
16990 MONTEREY RD, LAKE ELSINORE, CA 92530-7529
(951) 609-1980
Mailing address
16990 MONTEREY RD, LAKE ELSINORE, CA 92530-7529
(951) 609-1980
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP4079
CA
Other
Enumeration date
12/29/2011
Last updated
12/29/2011
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