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Individual

JOHN GRANGER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
6818 GROVER ST STE 301, OMAHA, NE 68106-3632
(531) 466-2326
(531) 772-0266
Mailing address
3240 S 45TH ST, OMAHA, NE 68106-4028
(531) 466-2326
(531) 772-0266

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1326
NE
101YA0400X
Addiction (Substance Use Disorder) Counselor
20008
IA
101YM0800X
Mental Health Counselor
099193
IA
101YM0800X
Mental Health Counselor
Primary
2008
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
10027158400
NE
Enumeration date
12/06/2019
Last updated
08/11/2022
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