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NPI Code Detail

MEDICARE: HEATHER RENEE GRANT

MEDICARE: HEATHER RENEE GRANT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst304229KY
2106S00000XBehavior TechnicianKY

General Provider Information

NPI Number : 1144927914
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEATHER RENEE GRANT
Provider Business Mailing Address
First Line : 105 COLLEGE ST STE D
Second Line :
City : SOMERSET
State : KY
Zip : 42501-1307
Country : US
Telephone Number : 606-677-2636
Fax Number :
Provider Business Practice Location Address
First Line : 105 COLLEGE ST STE D
Second Line :
City : SOMERSET
State : KY
Zip : 42501-1307
Country : US
Telephone Number : 606-677-2636
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/13/2023
Last Update Date : 12/15/2025

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Directions to “ HEATHER RENEE GRANT ” Practice Location

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