CARTER LANE GRISSOM

UKIAH, CA
NPI1689090920
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2014-03-11
Last Update Date2025-09-22
Business Address
Mr. CARTER LANE GRISSOM
201 BRUSH ST
UKIAH, CA 95482-3424
Phone number: 707-462-6290
Mailing Address
Mr. CARTER LANE GRISSOM
201 BRUSH ST
UKIAH, CA 95482-3424
Phone number: 707-462-6290