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General NPI Number Information
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NPI Number | 1356096218
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Entity Type | Organization
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Legal Business Name | UNITED FAMILY THERAPY, LLC
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Dates
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Enumeration Date | 02/18/2022
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Last Update Date | 03/26/2023
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Provider Practice Location Address
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Address Line | 630 E CHURCH ST
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City | JASPER
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State | GA
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Zip | 30143-1312
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Country | US
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Telephone | 762-233-4869
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Fax | 706-510-2654
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Provider Business Mailing Address
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Address Line | 630 E CHURCH ST
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City | JASPER
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State | GA
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Zip | 30143-1312
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Country | US
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Telephone | 762-233-4869
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. HILDA BEATRIZ GRINDELL
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Credential | LCSW
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Telephone | 954-892-4767
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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