Individual
MARY ROBIN GROVE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRC, LPC
Contact information
Practice address
310 PAPER TRAIL WAY, 106, CANTON, GA 30115-5203
(678) 880-4645
Mailing address
310 PAPER TRAIL WAY, 106, CANTON, GA 30115-5203
(678) 880-4645
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC005065
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
45-5480838
—
GA
Enumeration date
10/17/2013
Last updated
10/17/2013
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