Individual
AMANDA ARIELLE GRANNUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
10839301
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10839301
LCSW LICENCE NUMBER
NY
Enumeration date
12/20/2019
Last updated
12/20/2019
Update your record
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