| NPI | 1417444910 |
|---|---|
| Doing Business As | MALLORY GRIMSTE, LCSW |
| Entity Type | Organization |
| Authorized Contact | MALLORY GRIMSTE Owner 203-228-8971 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2018-04-19 |
| Last Update Date | 2018-04-19 |