Individual
MS. M. CHARISSE GRANGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
100 POYDRAS ST, LAFAYETTE, LA 70501-4740
(337) 231-6365
Mailing address
100 POYDRAS ST, LAFAYETTE, LA 70501-4740
(337) 231-6365
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
3359
LA
Other
Enumeration date
11/20/2015
Last updated
11/20/2015
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