Mitzie L Grant in Philadelphia - Clinical Neuropsychologist
Mitzie L Grant - NPI 1063453439
Mitzie L Grant is a Clinical Neuropsychologist in Philadelphia, Pennsylvania. Mitzie L Grant practices all healthcare services and medical treatments related to Clinical Neuropsychologist. The NPI Number for Mitzie L Grant is 1063453439. The last update date is 2016-08-31.
Mitzie L Grant's current location address is 4641 Roosevelt Blvd, Philadelphia, Pennsylvania. You can contact this provider via phone number 2158314811 and fax number 2158312603. The mailing address for Mitzie L Grant is 4641 Roosevelt Blvd, Philadelphia, Pennsylvania. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Mitzie L Grant |
|---|---|
| Address | 4641 Roosevelt Blvd, Philadelphia, Pennsylvania |
| Phone Number | 2158314811 |
| Fax Number | 2158312603 |
| Sole Proprietor | N |
| Credentials | PHD. |
NPI Number Detail
| NPI Number | 1063453439 |
|---|---|
| Provider Enumeration Date | 2006-06-09 |
| Last Updated Date | 2016-08-31 |
Provider Mailing Address Detail
| Address | 4641 Roosevelt Blvd |
|---|---|
| City | Philadelphia |
| State | Pennsylvania (PA) |
| Post Code | 191242343 |
| Phone Number | 2158314811 |
| Fax Number | 2158312603 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical Neuropsychologist |
|---|---|
| Taxonomy | 103G00000X |
| Licence No | PS008501L |
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Definition: A clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing th |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1685355 | PA | -- |
Post Comment/ Review Below
What is the unique 10-digit identifier code issued to Mitzie L Grant by the Centers for Medicare & Medicaid Services?
The Mitzie L Grant has been assigned the NPI (National Provider Identifier) 1063453439 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Could you provide the complete address where Mitzie L Grant is physically located?
The Mitzie L Grant is situated at the following address: 4641 Roosevelt Blvd, Philadelphia, PA 191242343.
What is Mitzie L Grant's area of expertise and its corresponding taxonomy classification?
The Mitzie L Grant's field of specialization is Clinical Neuropsychologist, and it falls under the taxonomy code 103G00000X, which categorizes healthcare providers based on their areas of practice.
When was the Mitzie L Grant's 1063453439 issued?
The Mitzie L Grant's 1063453439 was issued on 2006-06-09.
When was the information regarding Mitzie L Grant, such as address, specialty, and other details, most recently verified or confirmed to be accurate?
The information pertaining to Mitzie L Grant, including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2016-08-31.
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