Individual
BETTY GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1505 W HIGHLAND AVE, SUITE 19, SAN BERNARDINO, CA 92411-1253
(909) 522-4656
Mailing address
1505 W HIGHLAND AVE, SUITE 19, SAN BERNARDINO, CA 92411-1253
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
04/04/2012
Last updated
04/04/2012
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