Provider Demographics
NPI:1598390213
Name:GRANN, ALLISON LEIGH (MS OTR/L)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:LEIGH
Last Name:GRANN
Suffix:
Gender:F
Credentials:MS OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 MERRIMACK ST APT 8
Mailing Address - Street 2:
Mailing Address - City:PENACOOK
Mailing Address - State:NH
Mailing Address - Zip Code:03303-1455
Mailing Address - Country:US
Mailing Address - Phone:774-482-0869
Mailing Address - Fax:
Practice Address - Street 1:66 NORTH RD
Practice Address - Street 2:
Practice Address - City:DEERFIELD
Practice Address - State:NH
Practice Address - Zip Code:03037-1325
Practice Address - Country:US
Practice Address - Phone:603-463-7422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-04
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2985225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH2985OtherOCCUPATIONAL THERAPY LICENSE