Individual
AMANDA ANN GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
231 MAIN ST, BROCKTON, MA 02301-4342
(513) 834-7063
Mailing address
4600 MONTGOMERY RD STE 400, CINCINNATI, OH 45212-2600
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
04/29/2022
Last updated
10/03/2023
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