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NPI Code Detail

MEDICARE: STEPHANIE- JOY CAMILLE GRIGG

MEDICARE:   STEPHANIE- JOY CAMILLE GRIGG
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1962116327
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE- JOY CAMILLE GRIGG
Provider Business Mailing Address
First Line : 939 S HILL ST APT 501
Second Line :
City : LOS ANGELES
State : CA
Zip : 90015-3098
Country : US
Telephone Number : 516-806-8441
Fax Number :
Provider Business Practice Location Address
First Line : 1630 CENTINELA AVE
Second Line :
City : INGLEWOOD
State : CA
Zip : 90302-1041
Country : US
Telephone Number : 323-457-0997
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/10/2023
Last Update Date : 01/10/2023

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Directions to “ STEPHANIE- JOY CAMILLE GRIGG ” Practice Location

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