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Individual

DR. LAURA DIANE MAYNARD GRANT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PSYD

Contact information

Practice address
7 HADLEY ST, SUITE 4, SOUTH HADLEY, MA 01075-1147
(786) 269-7819
(413) 437-7826
Mailing address
7 HADLEY ST, SUITE 4, SOUTH HADLEY, MA 01075-1147
(786) 269-7819
(413) 437-7826

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
05078
MD
103TC0700X
Clinical Psychologist
Primary
9903
MA

Other

Enumeration date
06/06/2014
Last updated
06/06/2014
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