Individual
CHESS CHARLES GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCDC, ADS
Contact information
Practice address
700 TX-16 S BANDERA TEXAS 78003, SAME, BANDERO, TX 78003-7800
(830) 225-1622
Mailing address
700 TX-16 S BANDERA TEXAS 78003, SAME, BANDERO, TX 78003
(830) 225-1622
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
5546
TX
Other
Enumeration date
11/09/2022
Last updated
11/09/2022
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