Individual
MARK GRANGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4935 PETE NATION RD, STARKS, LA 70661-4025
(337) 540-8518
Mailing address
4935 PETE NATION RD, STARKS, LA 70661-4025
(337) 540-8518
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
L-101
LA
Other
Enumeration date
09/25/2015
Last updated
09/25/2015
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