Individual
MADELINE GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
1416 MONROE AVE, DUNMORE, PA 18509-2477
(570) 483-8956
Mailing address
62 HILDEBRANDT RD, DALLAS, PA 18612-9058
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
SW140610
PA
Other
Enumeration date
04/11/2024
Last updated
04/11/2024
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