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Organization
EMERALD PALACE PRACTICE PLLC
Active
Organization
EMERALD PALACE PRACTICE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRIAN R GRANDJEAN MA, LPC (LICENSED PROFESSIONAL COUNSELOR)
(214) 866-9529
Entity
Organization
Contact information
Practice address
6200 CHASE OAKS BLVD, SUITE 103, PLANO, TX 75023-4652
(214) 866-9529
(469) 241-0556
Mailing address
PO BOX 863, ALLEN, TX 75013-0014
(214) 866-9529
(469) 241-0556
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
197756
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
181137402
—
TX
Enumeration date
01/22/2009
Last updated
01/22/2009
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