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General NPI Number Information
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NPI Number | 1528092376
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Entity Type | Individual
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Provider Name | DEBRA T GRANT LPC MHSP
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Gender | Female
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Dates
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Enumeration Date | 07/10/2006
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Last Update Date | 04/09/2012
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Provider Practice Location Address
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Address Line | 506 MAPLE ST
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City | ATHENS
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State | TN
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Zip | 37303-2938
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Country | US
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Telephone | 423-746-2441
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Fax | 423-746-2442
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Provider Business Mailing Address
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Address Line | PO BOX 564
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City | ATHENS
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State | TN
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Zip | 37371-0564
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Country | US
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Telephone | 423-746-2441
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Fax | 423-746-2442
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LPC1851
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License Number State | TN
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