Individual
ALYSON M GRANTHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
380 POLK ST, GREENWOOD, IN 46143-1623
(317) 888-1557
Mailing address
6398 N 75 W, WHITELAND, IN 46184-9533
(317) 370-7338
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-25-412135
IN
Other
Enumeration date
01/21/2025
Last updated
02/18/2025
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