Individual
LARRISSA GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7720 WOODLAND AVE APT G14, CLEVELAND, OH 44104-6815
(216) 356-7398
Mailing address
7720 WOODLAND AVE APT G14, CLEVELAND, OH 44104-6815
(216) 848-6245
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0255328
—
OH
Enumeration date
08/26/2018
Last updated
08/26/2018
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