MEDICARE: RENATA GRANGER MSW

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
1	104100000X	Social Worker	13750	LA

General Provider Information

NPI Number	:	1508215633
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RENATA GRANGER MSW

Provider Business Mailing Address
First Line	:	300 N BROAD ST
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70119-5577
Country	:	US
Telephone Number	:	504-293-7918
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 N BROAD ST
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70119-5577
Country	:	US
Telephone Number	:	504-293-7918
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2016
Last Update Date	:	06/09/2016

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Directions to “ RENATA GRANGER MSW” Practice Location

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