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Individual
MR. TIMOTHY LEE GRANT
Active
Individual
MR. TIMOTHY LEE GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MHPP
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LADAC 0190L
AR
101YM0800X
Mental Health Counselor
—
—
Other
Enumeration date
08/30/2006
Last updated
08/10/2011
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