MRS. Allie Grantham, MHR, LPC, CADC

NPI #1447388178 in Tahlequah, Oklahoma

Provider Information

NPI Number: 1447388178
Entity Type: Individual
Name: MRS. Allie Grantham, MHR, LPC, CADC
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Counselor
Credential: MHR, LPC, CADC
Enumeration Date: Mar 2, 2007
Last Updated: Oct 16, 2019

Practice Location

Address: 529 N OAK AVE
City: Tahlequah
State: Oklahoma
ZIP Code: 74464
Phone: (918) 444-2126

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder)	101YA0400X
Counselor	101Y00000X	Primary

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