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General NPI Number Information
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NPI Number | 1114252426
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Entity Type | Organization
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Legal Business Name | DEANNA R. GRIM, ED.D., INC.
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Dates
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Enumeration Date | 10/05/2009
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Last Update Date | 08/04/2014
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Provider Practice Location Address
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Address Line | 320 MAXWELL RD SUITE 600 C
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City | ALPHARETTA
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State | GA
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Zip | 30009-2070
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Country | US
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Telephone | 678-300-4746
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Fax |
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Provider Business Mailing Address
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Address Line | 320 MAXWELL RD SUITE 600 C
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City | ALPHARETTA
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State | GA
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Zip | 30009-2070
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Country | US
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Telephone | 678-300-4746
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Fax |
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Authorized Official
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Title or Position | OWNER/CEO
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Name | DR. DEANNA R. GRIM
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Credential | LPC
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Telephone | 678-300-4746
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC 615
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License Number State | GA
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