Ms. Keisha Latia Grundy
Mental Health
43825 Michigan Ave
Canton
, Michigan 48188-2551
Ms. Keisha Latia Grundy
Mental Health
43825 Michigan Ave
Canton
, Michigan 48188-2551
(317) 523-4539
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About
Features
Specialties
- Mental Health
Languages spoken
- English
Location
First Address
- Ms. Keisha Latia Grundy
- 14230 Ardmore St
- Detroit, MI
- Zip : 48227-3111
- Phone : (317) 523-4539
Second Address
- Ms. Keisha Latia Grundy
- 43825 Michigan Ave
- Canton, MI
- Zip : 48188-2551
- Phone : (317) 523-4539
Reviews
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Is Ms. Keisha Latia Grundy a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 225XM0800X | Mental Health |
National Provider Identifier
| NPI | 1730843368 |
|---|---|
| Provider Name | Ms. Keisha Latia Grundy |
| First Address | Detroit, MI 48227-3111 |
| Second Address | Canton, MI 48188-2551 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 29/10/2021 |
| Last Update Date | 29/10/2021 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.