| Doctor Name: | MR. GORDON M GRANTIER |
| NPI Number: | 1013092907 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LMHC |
| License Number: | 001788-1 |
| Business Practice Address: | 4220 State Rte 417w Wellsville, NY - 148959332 |
| Business Phone Number: | 5855936300 |
| Business Fax Number: | 5855937071 |
| Mailing Address: | 2794 State Rte 248, WELLSVILLE |
| State: | NY |
| Postal Code: | 148959667 |
| Phone Number: | 5855932151 |
| Fax Number: | |
| NPI Enumeration Date: | 10/26/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 001788-1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |