Individual
GRANT URBAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8817 LONG STREET, LENEXA, KS 66202
(913) 475-1095
Mailing address
5143 MAPLE AVE, MISSION, KS 66202-1825
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/24/2023
Last updated
04/24/2023
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