Individual provider · Type 1 NPI

Anja Lee Grissom, MED & LPC

Professional Counselor · Konawa, OK

NPI number 1235329699 Active

Practice location

527 W 3rd St
Konawa, OK 74849-1415

Fax (580) 925-2362

Specialties and licenses

TaxonomyCodeLicense
Professional Counselor Primary 101YP2500X2478 (OK)

Professional Counselor: Definition to come...

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About NPI 1235329699

Anja Lee Grissom, MED & LPC's National Provider Identifier is 1235329699, issued on Jul 31, 2007. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Konawa, OK. The record was last updated on Feb 12, 2010.