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General NPI Number Information
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NPI Number | 1386816080
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Entity Type | Individual
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Provider Name | MR. CHRISTOPHER LEIGH GRANT
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Gender | Male
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Dates
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Enumeration Date | 04/02/2008
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Last Update Date | 05/10/2023
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Provider Practice Location Address
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Address Line | 283 SOUTH BUTLER ROAD WELLSPAN PHILHAVEN INPATIENT
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City | LEBANON
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State | PA
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Zip | 17042
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Country | US
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Telephone | 717-273-8871
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Fax |
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Provider Business Mailing Address
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Address Line | 3811 OHARA ST
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City | PITTSBURGH
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State | PA
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Zip | 15213-2593
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PS017924
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License Number State | PA
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