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NPI Code Detail

MEDICARE: DANIELA NICOLE GRANT

MEDICARE: DANIELA NICOLE 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
1106S00000XBehavior TechnicianBACB1463977OK

General Provider Information

NPI Number : 1598629735
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIELA NICOLE GRANT
Provider Business Mailing Address
First Line : 1717 S AIR DEPOT BLVD
Second Line :
City : MIDWEST CITY
State : OK
Zip : 73110-5103
Country : US
Telephone Number : 405-622-4239
Fax Number :
Provider Business Practice Location Address
First Line : 1717 S AIR DEPOT BLVD
Second Line :
City : MIDWEST CITY
State : OK
Zip : 73110-5103
Country : US
Telephone Number : 405-622-4239
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/11/2025
Last Update Date : 12/11/2025

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Directions to “ DANIELA NICOLE GRANT ” Practice Location

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