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General NPI Number Information
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NPI Number | 1023037298
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Entity Type | Organization
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Legal Business Name | GREW, MORTER & HARTYE, PA
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Dates
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Enumeration Date | 07/19/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3141 JOHN HUMPHRIES WYND
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City | RALEIGH
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State | NC
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Zip | 27612-5438
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Country | US
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Telephone | 919-783-5431
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Fax | 919-783-6480
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Provider Business Mailing Address
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Address Line | 3141 JOHN HUMPHRIES WYND
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City | RALEIGH
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State | NC
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Zip | 27612-5438
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Country | US
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Telephone | 919-783-5431
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Fax | 919-783-6480
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Authorized Official
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Title or Position | PRESIDENT, PSYCHOLOGIST
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Name | DR. MARYANNE HARTYE
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Credential | PH.D.
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Telephone | 919-783-5431
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 2211
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 850
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 1285
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License Number State | NC
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Taxonomy #4
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 2695
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License Number State | NC
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Taxonomy #5
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 2885
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License Number State | NC
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Taxonomy #6
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 3188
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License Number State | NC
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