Individual
DR. BRUCE N GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
420 THOMASTON ST, ZEBULON, GA 30295-3387
(404) 960-1282
Mailing address
410 MURRY PARK, PEACHTREE CITY, GA 30269-2622
(770) 710-2173
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
103T00000X
Psychologist
2011035787
MO
103T00000X
Psychologist
Primary
PSY003711
GA
Other
Enumeration date
01/14/2008
Last updated
04/26/2016
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