Individual
JESSICA GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
123 AYLESWORT HALL NW, FORT COLLINS, CO 80521
(970) 491-5780
Mailing address
908 AKIN AVE, FORT COLLINS, CO 80521-2527
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
000992053
CO
Other
Enumeration date
11/08/2013
Last updated
06/14/2024
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