Individual
ALEXIS GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFT , CM II
Contact information
Practice address
807 SW F AVE, LAWTON, OK 73501-4506
(580) 284-8036
Mailing address
3821 NW BELL AVE, LAWTON, OK 73505-4960
(580) 284-8036
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
1201
OK
Other
Enumeration date
12/12/2016
Last updated
12/12/2016
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