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Organization

GRAIN OF SAND ACADEMY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LISA S KOVITCH (EXECUTIVE DIRECTOR)
(570) 982-9436
Entity
Organization

Contact information

Practice address
342 THE CHACE, SANDY SPRINGS, GA 30328-4246
(570) 982-9436
(678) 669-2632
Mailing address
342 THE CHACE, SANDY SPRINGS, GA 30328-4246
(570) 982-9436
(678) 669-2632

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
103K00000X
Behavior Analyst
Primary
225X00000X
Occupational Therapist

Other

Enumeration date
01/02/2019
Last updated
11/01/2021
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