MR. Shane Owen Grant
NPI #1043666779 in Manchester, Connecticut
Provider Information
- NPI Number
- 1043666779
- Entity Type
- Individual
- Name
- MR. Shane Owen Grant
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Counselor - Mental Health
- Enumeration Date
- May 12, 2016
- Last Updated
- May 12, 2016
Practice Location
- Address
- 91 ELM ST APT 312E
- City
- Manchester
- State
- Connecticut
- ZIP Code
- 06040-8632
- Phone
- (860) 969-7147
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - Mental Health — Mental Health |
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