Provider Demographics
NPI:1548304470
Name:GRAMBOW, LUANN (LPC)
Entity type:Individual
Prefix:MRS
First Name:LUANN
Middle Name:
Last Name:GRAMBOW
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 LILLIAN CIR
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28147-8544
Mailing Address - Country:US
Mailing Address - Phone:704-638-5937
Mailing Address - Fax:
Practice Address - Street 1:2200 MOORESVILLE RD
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28147-8816
Practice Address - Country:US
Practice Address - Phone:704-647-0059
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3929101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional