Individual
KAELA JANELLE GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
37200 N GANTZEL RD STE 150, SAN TAN VALLEY, AZ 85140-7383
(520) 484-1111
Mailing address
2743 E TRAIL BLAZER DR, SAN TAN VALLEY, AZ 85140-0022
(480) 544-1989
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BEH-001570
AZ
Other
Enumeration date
11/11/2024
Last updated
11/11/2024
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