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Individual

NICOLE GRANT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
B.A.

Contact information

Practice address
770 WOODLANE RD, WESTAMPTON, NJ 08060-3804
(856) 267-5928
Mailing address
2612 CLUBHOUSE DR, WEST DEPTFORD, NJ 08066-2111
(856) 885-3263

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary

Other

Enumeration date
01/31/2017
Last updated
01/31/2017
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