Individual
KERI INNIS-GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW PENDING
Contact information
Practice address
108 GROVE STREET, STE LL11, WORCESTER, MA 01605
(508) 304-7499
(774) 420-7255
Mailing address
108 GROVE ST STE LL11, WORCESTER, MA 01605-2677
(508) 304-7499
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
193200000X
MA
Other
Enumeration date
08/09/2018
Last updated
08/09/2018
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