Healthcare Provider Details

I. General information

NPI: 1053222661
Provider Name (Legal Business Name): ONA H GRANT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 WALNUT ST STE 204
PHILADELPHIA PA
19102-3502
US

IV. Provider business mailing address

321 LINCOLN AVE
LANSDOWNE PA
19050-1038
US

V. Phone/Fax

Practice location:
  • Phone: 215-720-1456
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: