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Individual

MS. CONNIE ANN GRAND

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LICENSED PROFESSIONA

Contact information

Practice address
202-1 NW 11TH ST, AVA, MO 65608-9731
(417) 683-4505
(417) 683-4505
Mailing address
ROUTE 1, BOX 408, AVA, MO 65608-9731
(417) 683-1162

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2002032332
MO

Other

Enumeration date
07/23/2007
Last updated
07/23/2007
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