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1194080515
MITCHELL G GRAYSON
LONGVIEW, TX
NPI
1194080515
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: TX 11574)
Enumeration Date
2012-07-11
Last Update Date
2012-07-11
Business Address
Mr. MITCHELL G GRAYSON LCDC
950 N 4TH ST
LONGVIEW, TX 75601-5436
Phone number: 903-758-0596
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Mailing Address
Mr. MITCHELL G GRAYSON LCDC
PO BOX 6800
LONGVIEW, TX 75608-6800
Phone number: 903-758-2471
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