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ELAINE GRANT LADAC

Addiction (Substance Use Disorder) >> Counselor >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1538554332

Individual Registrant:
 ELAINE  GRANT LADAC
Gender: F
Sole Proprietor

Location and contact information for practice:
152 S HAMLETSBURG RD  BROOKPORT, IL 62910-2961 US
Tel: 615-967-8978  Fax: --

Contact information for business:
152 S HAMLETSBURG RD  BROOKPORT, IL 62910-2961 US
Tel: 615-967-8978  Fax: --

Registration Information:
NPI: 1538554332
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y101YA0400XBehavioral Health & Social Service Providers
Counselor
Addiction (Substance Use Disorder)
TNLADAC

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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