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Individual
MR. GRANT THOMAS WILLMS
Active
Individual
MR. GRANT THOMAS WILLMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.MIN.
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
04986
IA
101YM0800X
Mental Health Counselor
Primary
04986
IA
101YP1600X
Pastoral Counselor
04986
IA
101YP2500X
Professional Counselor
04986
IA
1041C0700X
Clinical Social Worker
04986
IA
106H00000X
Marriage & Family Therapist
04986
IA
Other
Enumeration date
09/01/2010
Last updated
09/01/2010
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