KELSHAWN ANTHONY GRANT

PRINCETON, WV
NPI1477389427
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WV  0005489001)
Enumeration Date2024-09-09
Last Update Date2024-09-09
Business Address
KELSHAWN ANTHONY GRANT
200 12TH STREET EXT
PRINCETON, WV 24740-2329
Phone number: 304-425-9541
Mailing Address
KELSHAWN ANTHONY GRANT
200 12TH STREET EXT
PRINCETON, WV 24740-2329
Phone number: 304-425-9541