Individual
DAVID DUPRIEST GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
5 SAGE MEADOWS CT, O FALLON, MO 63366-4189
(803) 325-5427
Mailing address
5 SAGE MEADOWS CT, O FALLON, MO 63366-4189
(314) 474-0015
(314) 782-5387
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2022004385
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
490112443
—
MO
Enumeration date
08/02/2016
Last updated
04/26/2023
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