Individual
JACQUELINE YVONNE GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LGPC
Contact information
Practice address
5563 LANIER AVE, SUITLAND, MD 20746-6218
(434) 426-6494
(434) 426-6494
Mailing address
5563 LANIER AVE, SUITLAND, MD 20746-6218
(434) 426-6494
(434) 426-6494
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LGP15015
MD
Other
Enumeration date
05/13/2025
Last updated
05/13/2025
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