MEDICARE: DR. NATALIE GRUBBS LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1720493745
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NATALIE GRUBBS LPC

Provider Business Mailing Address
First Line	:	3701 NOBLE CREEK DR NW
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30327-5124
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	171 VILLAGE PKWY NE
Second Line	:	BUILDING 8
City	:	MARIETTA
State	:	GA
Zip	:	30067-4061
Country	:	US
Telephone Number	:	404-941-5437
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/28/2014
Last Update Date	:	06/28/2014

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