Individual
MR. ROBERT MARK GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, BCBA
Contact information
Practice address
345A GREENWOOD ST, WORCESTER, MA 01607-1753
(508) 363-0200
Mailing address
98 OLD FARM RD, LUNENBURG, MA 01462-1051
(978) 835-4776
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-12-11581
MA
Other
Enumeration date
10/29/2012
Last updated
10/02/2019
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