Individual
RACHAEL KELLIE GRANTHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
1825 E NORTHERN AVE, PHOENIX, AZ 85020-3940
(602) 997-2880
Mailing address
1812 W KURALT DR, ANTHEM, AZ 85086-3629
(623) 341-4150
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
103TP2701X
Group Psychotherapy Psychologist
—
—
Other
Enumeration date
06/11/2017
Last updated
06/11/2017
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