Individual
KELLY GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
43825 MICHIGAN AVE, CANTON, MI 48188-2551
(734) 397-3088
(734) 397-0078
Mailing address
43825 MICHIGAN AVE, CANTON, MI 48188-2551
(734) 397-3088
(734) 397-0078
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
4704191116
MI
Other
Enumeration date
08/14/2014
Last updated
09/02/2014
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