Individual
DR. DAVID BRYANT GRANTHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ED.D.
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC0000001693
TN
106H00000X
Marriage & Family Therapist
LMT0000000581
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
015174
BLUE CROSS
TN
01
—
431961623
TAX ID
MS
Enumeration date
06/08/2006
Last updated
09/29/2008
Update your record
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