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General NPI Number Information
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NPI Number | 1902605751
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Entity Type | Individual
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Provider Name | SAVANNAH GRANDUSKY LPC-ASSOCIATE
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Gender | Female
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Dates
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Enumeration Date | 03/12/2025
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Last Update Date | 03/12/2025
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Provider Practice Location Address
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Address Line | 3701 ROBINHOOD DR
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City | TEMPLE
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State | TX
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Zip | 76502-2400
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Country | US
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Telephone | 254-931-0835
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Fax |
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Provider Business Mailing Address
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Address Line | 3809 S GENERAL BRUCE DR STE 103-113
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City | TEMPLE
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State | TX
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Zip | 76502-1035
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Country | US
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Telephone | 682-978-7874
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Fax |
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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 | 92489
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License Number State | TX
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