Individual
GINA GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
40 LEDGEVIEW WAY APT 1215, WRENTHAM, MA 02093-1918
(860) 416-7697
Mailing address
40 LEDGEVIEW WAY APT 1215, WRENTHAM, MA 02093-1918
(860) 416-7697
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
01/10/2022
Last updated
01/10/2022
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