Individual
MAX GRANTHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
425 BROADWAY ST, PADUCAH, KY 42001-0713
(270) 442-7121
Mailing address
425 BROADWAY ST, PADUCAH, KY 42001-0713
(270) 442-7121
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
06/02/2025
Last updated
06/02/2025
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