Mikaela Grant

NPI #1144965104 in Cheyenne, Wyoming

Provider Information

NPI Number: 1144965104
Entity Type: Individual
Name: Mikaela Grant
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Behavior Technician
Enumeration Date: May 3, 2022
Last Updated: May 3, 2022

Practice Location

Address: 3120 OLD FAITHFUL RD STE 100
City: Cheyenne
State: Wyoming
ZIP Code: 82001-5890
Phone: (307) 514-0215

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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