| Alexandra Grannan Licsw Llc | |
|
800 Lexington Street Waltham Plaza 1070 Waltham MA 02451 | |
| (617) 520-4115 | |
| Not Available |
| Full Name | Alexandra Grannan Licsw Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 800 Lexington Street, Waltham, Massachusetts |
| Authorized Official Name and Position | Alexandra Grannan (MANAGER, SOLE MEMBER) |
| Authorized Official Contact | 6175204115 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Alexandra Grannan Licsw Llc 800 Lexington Street Waltham Plaza 1070 Waltham MA 02451 Ph: () - | Alexandra Grannan Licsw Llc 800 Lexington Street Waltham Plaza 1070 Waltham MA 02451 Ph: (617) 520-4115 |
| NPI Number | 1871358077 |
|---|---|
| Provider Enumeration Date | 02/16/2024 |
| Last Update Date | 02/16/2024 |
| Certification Date | 02/15/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871358077 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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