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Individual

AUTUMN RENEE' GRANT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3900 ARMOUR AVE, FORT SMITH, AR 72904-4317
(479) 785-4083
(479) 783-1914
Mailing address
3900 ARMOUR AVE, FORT SMITH, AR 72904-4317
(479) 785-4083
(479) 783-1914

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Enumeration date
08/13/2014
Last updated
08/13/2014
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