NPI 1043591506

Rachel Grantham, LADC

Practitioner Addiction (Substance Use Disorder) Counselor Prior Lake, MN

Practice location

Address: 2330 Sioux Trl NW, Prior Lake, MN 55372-9077
Phone: (952) 496-6164

Registered specialties

Addiction (Substance Use Disorder) Counselor Primary

Behavioral Health & Social Service Providers Taxonomy 101YA0400X Licence 301722 (MN)

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Registry record

NPI: 1043591506
Entity type: Individual
Sex (as registered): Female
NPI issued: 29 Aug 2011
Record last updated: 29 Aug 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.