Doctor Name: | MS. MARCELLA E GRAYSON |
NPI Number: | 1396077541 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | L.C.S.W., L.A.C |
License Number: | 775 |
Business Practice Address: | 112 E Commercial Ave Anaconda, MT - 597112245 |
Business Phone Number: | 4064900124 |
Business Fax Number: | |
Mailing Address: | 112 E Commercial Ave, ANACONDA |
State: | MT |
Postal Code: | 597112245 |
Phone Number: | 4064900124 |
Fax Number: | |
NPI Enumeration Date: | 02/12/2010 |
NPI Last Update Date: | 02/12/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 775 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |