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Individual

ANABEL CANILLAS GRANT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMSW

Contact information

Practice address
1504 OGLETHORPE DR, HEPHZIBAH, GA 30815-0009
(443) 303-6307
Mailing address
1504 OGLETHORPE DR, HEPHZIBAH, GA 30815-0009

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
123794
NY
101YM0800X
Mental Health Counselor
16806
SC
101YM0800X
Mental Health Counselor
MSW011840
GA
104100000X
Social Worker
123794
NY
106S00000X
Behavior Technician

Other

Enumeration date
01/24/2022
Last updated
10/17/2025
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