Organization · Type 2 NPI
Grand Lake Therapeutics LLC
Professional Counselor · Grove, OK
NPI number
1528670239
Active
Practice location
1441 Lakeside Dr
Grove, OK 74344-4223
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Professional Counselor Primary | 101YP2500X | None listed |
Professional Counselor: Definition to come...
Other professional counselor providers in Grove
About NPI 1528670239
Grand Lake Therapeutics LLC's National Provider Identifier is 1528670239, issued on Aug 24, 2020. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Grove, OK. The record was last updated on Aug 24, 2020.