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General NPI Number Information
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NPI Number | 1679049902
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Entity Type | Individual
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Provider Name | MR. TOBAS ANTHONY GROVES
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Gender | Male
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Dates
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Enumeration Date | 10/14/2018
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Last Update Date | 10/14/2018
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Provider Practice Location Address
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Address Line | 1939 MADISON CT APT D
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City | CARMEL
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State | IN
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Zip | 46032-2957
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Country | US
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Telephone | 317-603-7713
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Fax |
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Provider Business Mailing Address
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Address Line | 1939 MADISON CT APT D
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City | CARMEL
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State | IN
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Zip | 46032-2957
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Country | US
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Telephone | 317-603-7713
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Fax |
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State | IN
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