Individual
MR. GRADY MITCHELL VANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC LICENSED PROFESS
Contact information
Practice address
2109 DARLINGTON ST, HOOVER, AL 35226
(205) 260-5138
(205) 533-8896
Mailing address
PO BOX 3441, HUEYTOWN, AL 35023-0441
(205) 260-5138
(205) 533-8896
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
2363
AL
101YM0800X
Mental Health Counselor
2363
AL
101YP2500X
Professional Counselor
2363
AL
Other
Enumeration date
10/23/2007
Last updated
10/23/2007
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