Grove, Mary Robin
Grove, Mary Robin is an sole proprietor health care provider with primary practice located at 310 Paper Trail Way 106, Canton GA 30115-5203. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Grove, Mary Robin can be contacted via phone (678) 880-4645.Contact Information
Primary practice address
310 Paper Trail Way 106
Canton GA 30115-5203
Phone: (678) 880-4645
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | LPC005065 | Georgia |
Profile Details
| NPI number | 1043648694 |
|---|---|
| LBN Legal business name | Grove, Mary Robin |
| Credentials | CRC, LPC |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 17th, 2013 |
| Last updated | Oct 17th, 2013 - 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 | 1043648694 | NPPES |
| Georgia | MEDICAID | 45-5480838 |
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