Individual
SHELLIE E. GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
635 PUTNAM PL, ALEXANDRIA, VA 22302-4019
(703) 548-2342
Mailing address
635 PUTNAM PL, ALEXANDRIA, VA 22302-4019
(703) 548-2342
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
0101035068
VA
Other
Enumeration date
04/13/2007
Last updated
07/08/2007
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