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Individual
JEANETTE GRANSTROM
Active
Individual
JEANETTE GRANSTROM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AA, BA, MACP
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CG 60151269
WA
Other
Enumeration date
01/13/2016
Last updated
01/13/2016
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