Individual
JEAN M GRANBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2731 COMMERCIAL WAY UNIT C, MONTROSE, CO 81401-5700
(970) 364-6910
Mailing address
1728 6429 CIR, MONTROSE, CO 81403-7148
(970) 249-7887
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0110404
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0110404
DORA
CO
Enumeration date
03/11/2020
Last updated
03/11/2020
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