Grantham, Rachel
Grantham, Rachel is an individual health care provider with primary practice located at 2330 Sioux Trl Nw , Prior Lake MN 55372-9077. She recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Grantham, Rachel can be contacted via phone (952) 496-6164.Contact Information
Primary practice address
2330 Sioux Trl Nw
Prior Lake MN 55372-9077
Phone: (952) 496-6164
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 301722 | Minnesota |
Profile Details
| NPI number | 1043591506 |
|---|---|
| LBN Legal business name | Grantham, Rachel |
| Credentials | LADC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 29th, 2011 |
| Last updated | Aug 29th, 2011 - about 13 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1043591506 | NPPES |
| Minnesota | Other | 301722 | LADC LIC |
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