Organization
4TH AND GROVE LLC
Active
Other names
4th and Grove Counseling LLC
Organization subpart
No
Provider details
NPI number
Authorized official
ROSANA GILLES-LAMONTAGNE LPC (OWNER)
(856) 441-5216
Entity
Organization
Contact information
Practice address
480 DEFRANCESCO CIR, GLASSBORO, NJ 08028-4906
(856) 441-5216
Mailing address
PO BOX 752, GLASSBORO, NJ 08028-0752
(856) 441-5216
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
07/22/2021
Last updated
07/22/2021
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