| NPI | 1700482601 |
|---|---|
| Former Legal Business Name | GROW THERAPEUTIC SERVICES, PLLC |
| Entity Type | Organization |
| Authorized Contact | CEYONNA LEWIS Program Director 443-842-4952 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 251S00000X |
| 101Y00000X Counselor | |
| 101YM0800X Counselor, Mental Health | |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2020-12-07 |
| Last Update Date | 2024-01-08 |