Individual
CARLA GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M. A.
Contact information
Practice address
2406C WEST ST, WINNSBORO, LA 71295
(318) 435-7715
(318) 435-7708
Mailing address
2406C WEST ST, WINNSBORO, LA 71295-3843
(318) 435-7715
(318) 435-7708
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1316187321
NPI
LA
Enumeration date
05/09/2016
Last updated
08/01/2018
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