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Individual

MR. DAVID LAWRENCE GRANT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
6900 78TH AVE N STE 100, BROOKLYN PARK, MN 55445-2719
(763) 432-6875
(833) 933-0639
Mailing address
4104 WASHBURN AVE N, MINNEAPOLIS, MN 55412-1530
(612) 588-2999

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
MN

Other

Enumeration date
11/08/2021
Last updated
06/28/2022
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