Individual
MRS. EDIE DIANE GRIZZLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, LMAC
Contact information
Practice address
210 W 21ST ST, CONCORDIA, KS 66901-5200
(785) 243-8900
(785) 243-8933
Mailing address
425 N WASHINGTON ST, JUNCTION CITY, KS 66441-3686
(785) 236-1178
(785) 579-5456
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
020
KS
101YP2500X
Professional Counselor
Primary
2397
KS
Other
Enumeration date
05/21/2012
Last updated
09/10/2020
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