Individual
ANTHONY A GRANBERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
THD, LPC, LMFT
Contact information
Practice address
1276 MCCONNELL DR STE A, DECATUR, GA 30033-3533
(404) 954-2324
Mailing address
1276 MCCONNELL DR STE A, DECATUR, GA 30033-3533
(404) 954-2324
Taxonomy
Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
—
—
101YP2500X
Professional Counselor
Primary
LPC005075
GA
106H00000X
Marriage & Family Therapist
MFT001232
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
219747233A
—
GA
Enumeration date
01/23/2007
Last updated
07/10/2012
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