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General NPI Number Information
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NPI Number | 1003784679
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Entity Type | Organization
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Legal Business Name | GROOVE TO GROW THERAPY
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Dates
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Enumeration Date | 10/27/2025
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Last Update Date | 10/27/2025
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Provider Practice Location Address
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Address Line | 1012 COLLEGE RD STE 204 SUITE 204
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City | DOVER
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State | DE
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Zip | 19904-6506
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Country | US
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Telephone | 470-392-9695
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Fax |
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Provider Business Mailing Address
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Address Line | 1012 COLLEGE RD STE 204
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City | DOVER
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State | DE
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Zip | 19904-6506
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | RBT/ OWNER
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Name | MR. ANTWON TREVONN COLLINS SR.
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Credential |
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Telephone | 470-392-9695
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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