Individual
SHELLY ANN GRANTHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
6400 BARRIE RD APT 970, EDINA, MN 55435-2300
(612) 913-0017
Mailing address
6400 BARRIE RD APT 970, EDINA, MN 55435-2300
(612) 913-0017
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
3324
CT
Other
Enumeration date
01/10/2023
Last updated
01/10/2023
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