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General NPI Number Information
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NPI Number | 1144433657
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Entity Type | Individual
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Provider Name | JODINE M GRUNDY M.ED, L.P.C.
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Gender | Female
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Dates
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Enumeration Date | 05/08/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 330 W 4TH ST #3
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City | CINCINNATI
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State | OH
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Zip | 45202-2680
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Country | US
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Telephone | 513-784-1336
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Fax |
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Provider Business Mailing Address
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Address Line | 3481 MORRISON PL
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City | CINCINNATI
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State | OH
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Zip | 45220-1530
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Country | US
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Telephone | 513-751-6115
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Fax | 513-751-3131
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | C-0002677
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License Number State | OH
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