Individual
MR. DEWAYNE C GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LPC 006829
GA
101YP2500X
Professional Counselor
Primary
LPC006829
GA
106H00000X
Marriage & Family Therapist
LPC 006829
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003152990A
—
GA
05
—
003160809A
—
GA
Enumeration date
08/09/2013
Last updated
08/03/2015
Update your record
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