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General NPI Number Information
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NPI Number | 1538815204
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Entity Type | Individual
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Provider Name | ERIKA MARIE GRANT PSYD
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Gender | Female
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Dates
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Enumeration Date | 02/22/2022
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Last Update Date | 10/07/2024
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Provider Practice Location Address
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Address Line | 1125 S LINDEN RD STE 200
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City | FLINT
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State | MI
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Zip | 48532-4073
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Country | US
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Telephone | 810-262-2320
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Fax |
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Provider Business Mailing Address
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Address Line | 235 WEALTHY ST SE
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City | GRAND RAPIDS
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State | MI
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Zip | 49503-5247
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Country | US
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Telephone | 616-840-8000
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Fax | 616-840-9642
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 6351004574
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 6351004574
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License Number State | MI
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