Individual
AEDAMAR JACINTA GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1107 E CARSON ST, FLOOR 2, PITTSBURGH, PA 15203-1153
(412) 481-4207
Mailing address
619 EVERGREEN LN, SEWICKLEY, PA 15143-1060
(412) 749-9050
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
PS-006396-L
PA
Other
Enumeration date
10/23/2006
Last updated
07/08/2007
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