Provider Demographics
NPI:1740599539
Name:GRANT, RACENT (BCBA)
Entity Type:Individual
Prefix:MS
First Name:RACENT
Middle Name:
Last Name:GRANT
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 W JASPER DR STE 9
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76542-1328
Mailing Address - Country:US
Mailing Address - Phone:254-265-8655
Mailing Address - Fax:254-556-3507
Practice Address - Street 1:1010 W JASPER DR STE 9
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76542-1328
Practice Address - Country:US
Practice Address - Phone:254-265-8655
Practice Address - Fax:254-556-3507
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-28
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst