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Individual

STACI GRANT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
976 BERNARDSTON RD, GREENFIELD, MA 01301-1159
(508) 335-1679
Mailing address
976 BERNARDSTON RD, GREENFIELD, MA 01301-1159
(508) 335-1679

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
5740
MA

Other

Enumeration date
11/30/2006
Last updated
05/29/2008
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