Individual
MR. DARRELL GENE GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
3905 ZELL CIR, DE SOTO, MO 63020-5476
(636) 586-4185
Mailing address
3905 ZELL CIR, DE SOTO, MO 63020-5476
(636) 586-4185
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
000100
MO
Other
Enumeration date
12/26/2009
Last updated
12/26/2009
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