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NPI Code Detail

MEDICARE: MS. MARY P GROSSMAN MFT

MEDICARE: MS. MARY P GROSSMAN MFT
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
1101YM0800XMental Health CounselorMFC43788CA

General Provider Information

NPI Number : 1760556831
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MARY P GROSSMAN MFT
Provider Business Mailing Address
First Line : 1664 BROADWAY
Second Line :
City : EL CAJON
State : CA
Zip : 92021-5201
Country : US
Telephone Number : 619-579-8685
Fax Number : 619-576-1969
Provider Business Practice Location Address
First Line : 1664 BROADWAY
Second Line :
City : EL CAJON
State : CA
Zip : 92021-5201
Country : US
Telephone Number : 619-579-8685
Fax Number : 619-576-1969
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/20/2006
Last Update Date : 07/08/2007

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Directions to “ MS. MARY P GROSSMAN MFT” Practice Location

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