Individual
TIANA GRANVILLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2905 WAVERLY PLACE DR, DACULA, GA 30019-2922
(678) 223-1122
Mailing address
2905 WAVERLY PLACE DR, DACULA, GA 30019-2922
(678) 223-1122
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
—
—
374U00000X
Home Health Aide
—
—
376J00000X
Homemaker
—
—
376K00000X
Nurse's Aide
Primary
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
08/21/2023
Last updated
08/21/2023
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