Individual
MS. JESSICA REGINA GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
66 CANAL ST., BOSTON, MA 02114
(617) 371-3040
(617) 371-3038
Mailing address
1171 BOYLSTON ST., APT # 3, BOSTON, MA 02215
(617) 619-5937
(617) 371-3038
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
09/15/2014
Last updated
09/15/2014
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