Individual
SUSAN GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
708 W MAIN ST, WOODVILLE, OH 43469-1018
(419) 862-1070
Mailing address
708 W MAIN ST, WOODVILLE, OH 43469-1018
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
TU1006454
OH
Other
Enumeration date
04/30/2014
Last updated
04/30/2014
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