Individual
ALLYN BROOKE GRANADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
387 65TH ST, SPRINGFIELD, OR 97478-7067
(541) 291-2716
Mailing address
PO BOX 2022, WHITE CITY, OR 97503-0022
(541) 234-4781
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C4792
OR
Other
Enumeration date
03/02/2018
Last updated
09/04/2024
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