JEANETTE GRANSTROM AA, BA, MACP
NPI 1891151361
Counselor - Mental Health in Fife, WA
Active since January 13, 2016
About Jeanette Granstrom Aa, Ba, Macp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JEANETTE GRANSTROM AA, BA, MACP (NPI 1891151361) is an individual mental health provider in Fife, Washington, licensed in Washington (CG 60151269) and active in the NPI registry since January 2016.
NPPES Registry Identity
NPI1891151361
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameJEANETTE GRANSTROMCredential: AA, BA, MACP
Location Address4047 HERITAGE AVE EFife, WA 98424-3798
Mailing Address4047 Heritage Ave EFife, WA 98424-3798 · (253) 259-8645
Phone(253) 259-8645
Sole ProprietorYes
Enumeration DateJanuary 13, 2016
✔ NPI 1891151361 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in WA · CG 60151269
4047 HERITAGE AVE E, Fife, WA 98424
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1891151361, enumerated as an "individual" on January 13, 2016.
The provider is located at 4047 HERITAGE AVE E FIFE, WA 98424 and the phone number is (253) 259-8645.
Counselor with taxonomy code 101YM0800X and a focus in Mental Health.
