Individual
MS. TAKIESA GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.AC.
Contact information
Practice address
7750 MONTPELIER RD, LAUREL, MD 20723-6010
(912) 596-8911
Mailing address
10645 GRAMERCY PL, #351, COLUMBIA, MD 21044-6073
(912) 596-8911
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
U02158
MD
Other
Enumeration date
06/24/2014
Last updated
06/24/2014
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