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1922847813
TYRESE MYKEIL GRANT
GOOSE CREEK, SC
NPI
1922847813
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2024-05-21
Last Update Date
2024-05-21
Business Address
TYRESE MYKEIL GRANT
96 WISTERIA RD
GOOSE CREEK, SC 29445-3495
Phone number: 843-797-7871
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Mailing Address
TYRESE MYKEIL GRANT
96 WISTERIA RD
GOOSE CREEK, SC 29445-3495
Phone number: 843-797-7871
Copy
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