Individual
MRS. PORTIA M GRANGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
156 MORRELL CIR, HATTIESBURG, MS 39402-8132
(601) 434-1510
Mailing address
156 MORRELL CIR, HATTIESBURG, MS 39402-8132
(601) 434-1510
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
C7819
MS
Other
Enumeration date
04/28/2016
Last updated
04/28/2016
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