Provider Demographics
NPI:1184358343
Name:GRANGER, AMBER MICHELLE
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:MICHELLE
Last Name:GRANGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3640 N BRIARWOOD LN
Mailing Address - Street 2:
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47304-6375
Mailing Address - Country:US
Mailing Address - Phone:228-363-5785
Mailing Address - Fax:
Practice Address - Street 1:3640 N BRIARWOOD LN
Practice Address - Street 2:
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47304-6375
Practice Address - Country:US
Practice Address - Phone:463-777-9424
Practice Address - Fax:765-288-6520
Is Sole Proprietor?:No
Enumeration Date:2022-07-13
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)