Individual
TRACY LYNN GRANTHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
4130 FABER PLACE DR, SUITE 115, N CHARLESTON, SC 29405-8501
(843) 747-5327
(843) 747-0698
Mailing address
4130 FABER PLACE DR, SUITE 115, N CHARLESTON, SC 29405-8501
(843) 747-5327
(843) 747-0698
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
2835
SC
Other
Enumeration date
05/18/2011
Last updated
05/18/2011
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