Individual
JONATHAN JOSEPH GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
591 LAKEHURST RD # 8045, TOMS RIVER, NJ 08755-8045
(732) 367-4700
Mailing address
PO BOX 2036, LAKEWOOD, NJ 08701-8036
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0029807
—
NJ
Enumeration date
09/29/2022
Last updated
09/29/2022
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