Individual
MYRISSA GROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW,CSW
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
BP00946464
WV
1041S0200X
School Social Worker
Primary
257731
KY
Other
Enumeration date
02/08/2023
Last updated
01/14/2026
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