Grantham, David Bryant

Grantham, David Bryant is an sole proprietor health care provider with primary practice located at 296 Gamble Ave , Maryville TN 37801-4943. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Marriage & Family Therapist. Behavioral Health & Social Service Providers / Professional is his primary health care specialty. Grantham, David Bryant can be contacted via phone (865) 980-6464.

Contact Information

Primary practice address
296 Gamble Ave Maryville TN 37801-4943
Phone: (865) 980-6464
Fax: (865) 977-6823
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X LPC0000001693 Tennessee
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X LMT0000000581 Tennessee

Profile Details

NPI number 1548200322
LBN Legal business name Grantham, David Bryant
Credentials ED.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 8th, 2006
Last updated Sep 29th, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1548200322 NPPES
Mississippi Other 431961623 TAX ID
Mississippi Other 015174 TAX ID

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