Individual
CASSANDRA GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3100 WASHINGTON RD, KENOSHA, WI 53144-1604
(414) 507-9646
Mailing address
1522 E FALCON GLN, OAK CREEK, WI 53154-3958
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
08/19/2019
Last updated
08/19/2019
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