Doctor Name: | MS. MARREN EBERLE GRANT |
NPI Number: | 1205080579 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 50329043501 |
Business Practice Address: | 2809 Denny Ave Pascagoula, MS - 395815301 |
Business Phone Number: | 2288092212 |
Business Fax Number: | |
Mailing Address: | 2101 Highway 90, GAUTIER |
State: | MS |
Postal Code: | 395535340 |
Phone Number: | 2284977900 |
Fax Number: | |
NPI Enumeration Date: | 11/12/2008 |
NPI Last Update Date: | 11/13/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 50329043501 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | UT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |