Individual
ELLEN ELIZABETH GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
1300 NIAGARA ST, BUFFALO, NY 14213-1503
(716) 308-6328
Mailing address
1300 NIAGARA ST, BUFFALO, NY 14213-1503
(716) 308-6328
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
R019331-1
NY
Other
Enumeration date
02/10/2010
Last updated
12/02/2014
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