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Individual

GRANT SANFORD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LICSW

Contact information

Practice address
593 EDDY ST, PROVIDENCE, RI 02903-4923
(401) 444-0796
Mailing address
167 NORWOOD AVE APT 8, CRANSTON, RI 02905-3951
(315) 408-6521

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
ISW03106
RI

Other

Enumeration date
10/20/2023
Last updated
10/20/2023
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