Individual
DAETON DEGRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
11569 LICK SKILLET RD, POTOSI, MO 63664-8225
(573) 705-6670
Mailing address
11569 LICK SKILLET RD, POTOSI, MO 63664-8225
(573) 705-6670
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2014013834
MO
Other
Enumeration date
10/12/2019
Last updated
02/01/2024
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