Doctor Name: | DEBORAH MARIE GRANBERRY |
NPI Number: | 1316084619 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS, LPC |
License Number: | P0002002 |
Business Practice Address: | 100 S Cherokee St Morrilton, AR - 721102656 |
Business Phone Number: | 5013544589 |
Business Fax Number: | |
Mailing Address: | Po Box 679, MORRILTON |
State: | AR |
Postal Code: | 721100679 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 01/30/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | P0002002 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AR |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |