Individual
TERESA MAE GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L, CHT, LMT
Contact information
Practice address
20 MITCHELL AVENUE, BINGHAMTON, NY 13903
(607) 762-2176
(607) 762-2002
Mailing address
20 MITCHELL AVENUE, BINGHAMTON, NY 13903
(607) 762-2176
(607) 762-2002
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
012390
NY
225XH1200X
Hand Occupational Therapist
Primary
004835-1
NY
Other
Enumeration date
01/06/2009
Last updated
03/03/2009
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