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Individual

MARY GRICE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSW-LCSW

Contact information

Practice address
109 W WATAUGA AVE, JOHNSON CITY, TN 37604-5621
(423) 232-2600
(423) 467-3644
Mailing address
1167 SPRATLIN PARK DR, GRAY, TN 37615-6205
(423) 467-3600
(423) 467-3644

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
7247
TN
1041C0700X
Clinical Social Worker
LC8876
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
311690099
ME
Enumeration date
08/20/2006
Last updated
02/18/2020
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