Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Mitzie L Grant, PHD

Individual provider Clinical Neuropsychologist · NPI 1063453439

Dr. Mitzie L Grant, PHD is a Clinical Neuropsychologist in Philadelphia, Pennsylvania. Licensed in Pennsylvania. Registered with an NPI since 2006.

Licensed in
PA
In the registry since
2006
What do these letters mean?
PHD — Doctor of Philosophy
A research doctorate. In healthcare it usually sits alongside a clinical licence.

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Practice location Address checks out

4641 Roosevelt Blvd Ste C229
Philadelphia, PA 19124-2343
Phone: (215) 831-4811
Fax: (215) 831-2603
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Neuropsychologist (primary) Taxonomy 103G00000X · Licence PS008501L (PA)

Record details

NPI number1063453439
Entity typeIndividual (Type 1)
GenderFemale
Credentials PHD
Sole proprietorNo
NPI enumeratedJune 9, 2006
Last updated in NPPESAugust 31, 2016

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