Individual
MR. PEYTON LEON GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S.
Contact information
Practice address
1115 W CHESTNUT ST, BROCKTON, MA 02301-7501
(601) 382-0859
Mailing address
1115 W CHESTNUT ST, BROCKTON, MA 02301-7501
(601) 382-0859
Taxonomy
Speciality
Code
Description
License number
State
101YS0200X
School Counselor
Primary
450363
MA
Other
Enumeration date
02/08/2012
Last updated
02/08/2012
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