Individual
LATONYA GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MAC, CSAC, SAP, QMHP
Contact information
Practice address
2856 FOREHAND DR, CHESAPEAKE, VA 23323-2006
(757) 705-5025
Mailing address
2856 FOREHAND DR, CHESAPEAKE, VA 23323-2006
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
0710102076
VA
Other
Enumeration date
07/16/2024
Last updated
07/16/2024
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