Individual
MS. EMILY JOYCE GRANDUSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CRC
Contact information
Practice address
303 W. 6TH STREET, JUNIOR, WV 26275-0324
(304) 997-2835
Mailing address
PO BOX 324, JUNIOR, WV 26275-0324
(304) 997-2835
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
172
WV
101YM0800X
Mental Health Counselor
172
WV
106H00000X
Marriage & Family Therapist
172
WV
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0023397001
—
WV
Enumeration date
06/06/2007
Last updated
12/15/2015
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