Individual
WINSTON GRANT LASSITER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCAS
Contact information
Practice address
1190 W ROOSEVELT BLVD, MONROE, NC 28110-2818
(704) 296-6200
Mailing address
1305 S CANNON BLVD, KANNAPOLIS, NC 28083-6232
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6111958
—
NC
Enumeration date
07/17/2007
Last updated
11/02/2007
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