Individual
JACQUELINE GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2221 HIGHWAY 39 N, MERIDIAN, MS 39301
(601) 581-1191
Mailing address
2221 HIGHWAY 39 N, MERIDIAN, MS 39301
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2614
AL
Other
Enumeration date
03/21/2007
Last updated
07/08/2007
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