Ellen M Grant, None
Behavior Technician in Gardena, CA. Individual provider (NPI-1).
NPI number1467106914
StatusActive
Last updated in NPPESFeb 4, 2022
Details
- NPI
- 1467106914
- Entity type
- Individual (NPI-1)
- Name
- Ellen M Grant
- Credential
- None
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Feb 3, 2022
- Certification date
- Feb 4, 2022
- Last updated
- Feb 4, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Other names
- Ellen Malinda Dawes (Former Name)
Practice location
1149 W. 190th Street, Suite 2200Gardena, CA 90248
Phone 310-856-0800 · Fax 855-568-2494
Mailing address
18726 S. Western Avenue, Suite 408Gardena, CA 90248
Phone 310-856-0800 · Fax 855-568-2494
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