Individual
LANCE JEREMIAH GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6004 MASTER ST, PHILADELPHIA, PA 19151-4427
(267) 295-2234
Mailing address
6004 MASTER ST, PHILADELPHIA, PA 19151-4427
(267) 295-2234
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BH007824
PA
Other
Enumeration date
01/29/2026
Last updated
02/02/2026
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