Individual
MRS. JANIS GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
7003 MAIN STREET, STRATFORD, CT 06614
(203) 375-5894
Mailing address
7003 MAIN ST, STRATFORD, CT 06614-1393
(203) 375-5894
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
667
CT
Other
Enumeration date
04/01/2009
Last updated
06/27/2011
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