Individual
BETHANY GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1485 INTERNATIONAL PKWY, LAKE MARY, FL 32746-5303
(800) 798-6035
(888) 235-6035
Mailing address
1485 INTERNATIONAL PKWY, LAKE MARY, FL 32746-5303
(800) 798-6035
(888) 235-6035
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202006064
VA
Other
Enumeration date
08/10/2010
Last updated
08/10/2010
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