Individual
GRANT KOENIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1 MILL RIDGE LN, CHESTER, NJ 07930-2488
(908) 914-2624
Mailing address
23 DAVIS ST APT 1, HARRISON, NJ 07029-2615
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
44SC05805400
NJ
Other
Enumeration date
09/24/2018
Last updated
09/24/2018
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