Doctor Name: | MR. WILLIAM GUY GRANT |
NPI Number: | 1265689996 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LPC |
License Number: | 8681 |
Business Practice Address: | 400 E Main St Kilgore, TX - 756625906 |
Business Phone Number: | 9039842787 |
Business Fax Number: | 9039840517 |
Mailing Address: | 400 E Main St, KILGORE |
State: | TX |
Postal Code: | 756625906 |
Phone Number: | 9039842787 |
Fax Number: | 9039840517 |
NPI Enumeration Date: | 08/25/2008 |
NPI Last Update Date: | 08/25/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 8681 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |