Individual
ALYSSA GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5072 S 135TH ST, OMAHA, NE 68137-1639
(402) 616-9876
(712) 355-5120
Mailing address
2412 S 11TH ST, COUNCIL BLUFFS, IA 51501-7407
(402) 616-9876
(712) 355-5120
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
104100000X
Social Worker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1114467040
CRYSTAL SHARP COUNSELING, ::C
—
Enumeration date
05/13/2022
Last updated
05/13/2022
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