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1477389427
KELSHAWN ANTHONY GRANT
PRINCETON, WV
NPI
1477389427
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WV 0005489001)
Enumeration Date
2024-09-09
Last Update Date
2024-09-09
Business Address
KELSHAWN ANTHONY GRANT
200 12TH STREET EXT
PRINCETON, WV 24740-2329
Phone number: 304-425-9541
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Mailing Address
KELSHAWN ANTHONY GRANT
200 12TH STREET EXT
PRINCETON, WV 24740-2329
Phone number: 304-425-9541
Copy
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