Individual
EMILY ANN GRANVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3007 HARBOR LN N STE 1200, PLYMOUTH, MN 55447-5103
(612) 445-8317
Mailing address
3007 HARBOR LN N STE 1200, PLYMOUTH, MN 55447-5103
(612) 445-8317
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
247200000X
Other Technician
—
—
Other
Enumeration date
02/07/2022
Last updated
04/25/2022
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