Individual
MR. GRANT PEMBERTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CMHC
Contact information
Practice address
321 N MALL DR, ST GEORGE, UT 84790-7302
(435) 862-8612
Mailing address
3910 LONDON LN, SANTA CLARA, UT 84765-5643
(435) 705-3678
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
8856945-6004
UT
Other
Enumeration date
06/13/2019
Last updated
06/13/2019
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