Doctor Name: | PHILLIP W GRAMLING |
NPI Number: | 1780684746 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LPC |
License Number: | 2369 |
Business Practice Address: | 105 Church St Suite B Rainbow City, AL - 359066242 |
Business Phone Number: | 2563931888 |
Business Fax Number: | |
Mailing Address: | 118 Oak Cir, GADSDEN |
State: | AL |
Postal Code: | 359015814 |
Phone Number: | 2563931888 |
Fax Number: | |
NPI Enumeration Date: | 07/29/2005 |
NPI Last Update Date: | 06/20/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 2369 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |