Individual
MR. JEFFREY RALPH GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.C.S.W.
Contact information
Practice address
4190 HIGHLAND DR, SUITE 210, SALT LAKE CITY, UT 84124-2600
(801) 274-0403
Mailing address
2860 LIVE OAK CIR, SALT LAKE CITY, UT 84117-5544
(801) 277-0421
(801) 278-8504
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
123965-3501
UT
Other
Enumeration date
12/08/2006
Last updated
07/08/2007
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