Individual
JANELLE LAVON GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2634 VILLAGE LN, BOSSIER CITY, LA 71112-2318
(318) 617-9347
Mailing address
2634 VILLAGE LN, BOSSIER CITY, LA 71112-2318
(318) 617-9347
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
225XM0800X
Mental Health Occupational Therapist
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
3747P1801X
Personal Care Attendant
—
—
Other
Enumeration date
06/12/2020
Last updated
07/01/2020
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