Individual
REBECCA GRANDEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
440 S MARKET AVE, SPRINGFIELD, MO 65806-2026
(832) 623-8718
Mailing address
2420 W CALVIN DR, OZARK, MO 65721-8481
(832) 623-8718
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
2013012334
MO
Other
Enumeration date
03/05/2015
Last updated
03/05/2015
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