Individual
MS. ALISA D GROVE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
4408 BEDFORD WAY, LEESBURG, FL 34748-1321
(407) 421-2031
Mailing address
4408 BEDFORD WAY, LEESBURG, FL 34748-1321
(407) 421-2031
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
122073300
—
FL
Enumeration date
09/16/2011
Last updated
05/30/2024
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