Individual provider · Type 1 NPI

Shelly Grantham

Mental Health Counselor · Madras, OR

NPI number 1639460157 Active

Practice location

125 SW C St
Madras, OR 97741

Fax (541) 475-6196

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1639460157

Shelly Grantham's National Provider Identifier is 1639460157, issued on May 2, 2011. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Madras, OR. The record was last updated on May 2, 2011.