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Individual

TIA GRANT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
9079 W POST RD STE 100, LAS VEGAS, NV 89148-2414
(833) 759-8720
Mailing address
5800 PURPLE HAZE ST, LAS VEGAS, NV 89148-4581
(217) 725-4148

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
NA
N/A
Enumeration date
03/06/2022
Last updated
09/15/2025
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