Individual
AUTUMN GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
150 W UNIVERSITY BLVD, MELBOURNE, FL 32901-6982
(321) 674-8000
Mailing address
150 W UNIVERSITY BLVD, MELBOURNE, FL 32901-6982
(321) 674-8000
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
02/11/2020
Last updated
02/11/2020
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