Ecclesia Grant, LDO

NPI 1437476868 · on the registry since 2010 · sole proprietor

Practice

Address: 5534 Old National Hwy
Suites 100-B
College Park, GA 30349
Phone: (404) 432-1772
Fax: (404) 890-5574
Organisation at this address: Eye Maz N Eye
Resilient Focused Family Therapy
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 2

Registry record

Primary taxonomy: 156FX1800X
156FX1800X
Licence states on file: GA
From the registry's licence fields, which are often incomplete.
Sex: Female
Record last updated: 2010-05-13

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Georgia