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Individual

DARIAN L GRANTHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1223 PORTER ST, GOLDSBORO, NC 27530-6713
(919) 734-1848
Mailing address
1223 PORTER ST, GOLDSBORO, NC 27530-6713
(919) 734-1848

Taxonomy

Speciality
Code
Description
License number
State
103TA0700X
Adult Development & Aging Psychologist
103TH0100X
Health Service Psychologist
372600000X
Adult Companion
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
47-3535658
NC
Enumeration date
07/10/2018
Last updated
07/10/2018
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