Individual
MR. GRANT THOMAS WILLMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.MIN.
Contact information
Practice address
20 FRANK ST, COUNCIL BLUFFS, IA 51503-4460
(712) 323-4478
(712) 323-4188
Mailing address
2132 S 42ND ST, OMAHA, NE 68105-2910
(402) 558-1858
(402) 558-8970
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
04986
IA
101YM0800X
Mental Health Counselor
Primary
04986
IA
101YP1600X
Pastoral Counselor
04986
IA
101YP2500X
Professional Counselor
04986
IA
1041C0700X
Clinical Social Worker
04986
IA
106H00000X
Marriage & Family Therapist
04986
IA
Other
Enumeration date
09/01/2010
Last updated
09/01/2010
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