Individual
MISS GWENDOLYN D GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2575 S CIMARRON RD, STE 104, LAS VEGAS, NV 89117-7653
(702) 476-2899
(702) 476-1575
Mailing address
8229 BRIGGS GULLY ST, NORTH LAS VEGAS, NV 89085-4431
(702) 788-3330
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
225400000X
Rehabilitation Practitioner
—
—
Other
Enumeration date
03/02/2011
Last updated
03/16/2016
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