Individual provider · Type 1 NPI
Jennifer Stuart Grissom
Mental Health Counselor · Shallotte, NC
NPI number
1659055507
Active
Practice location
5320 Bridgers Rd Ste 4
Shallotte, NC 28470-4737
Mailing address
6472 Rolling Run Rd
Southport, NC 28461-8302
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Counselor Primary | 101YM0800X | 0704013796 (VA) |
Mental Health Counselor: Definition to come...
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About NPI 1659055507
Jennifer Stuart Grissom's National Provider Identifier is 1659055507, issued on Jun 12, 2023. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Shallotte, NC. The record was last updated on Jun 12, 2023.