Individual
MS. VICKI ANN GRANTHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
6124 NORTHMOOR DR, LITTLE ROCK, AR 72204-2504
(501) 786-2433
(501) 614-7254
Mailing address
10801 PLATTE VALLEY DR, LITTLE ROCK, AR 72212-3654
(501) 786-2433
(501) 614-7254
Taxonomy
Speciality
Code
Description
License number
State
103TM1800X
Intellectual & Developmental Disabilities Psychologist
Primary
85-23EI
AR
Other
Enumeration date
12/18/2023
Last updated
12/18/2023
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