Individual
MICHELLE GRUNKEMEYER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2404 REFUGE RD, JASPER, GA 30143-4946
(706) 692-7209
Mailing address
1481 GREENWOOD CT, CANTON, GA 30115-8114
(678) 215-2007
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
APC006168
GA
Other
Enumeration date
03/20/2018
Last updated
06/16/2018
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