Individual
EMILY J GRANTHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
30 TECHNOLOGY DR, ROCKY MOUNT, VA 24151-3008
(276) 632-7128
(276) 632-0127
Mailing address
24 CLAY ST, MARTINSVILLE, VA 24112-2810
(276) 632-7128
(276) 632-0127
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904006022
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004945221
—
VA
Enumeration date
09/16/2005
Last updated
03/03/2010
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