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Jennifer Stuart Grissom
Mental Health Counselor in Shallotte, North Carolina
NPI 1659055507

Jennifer Stuart Grissom is a Mental Health Counselor based in Southport, NC and is specialized in Mental Health. Jennifer Stuart Grissom practices in Shallotte, NC. The NPI Number for Jennifer Stuart Grissom is 1659055507 and holds a License No. 0704013796 (North Carolina).

The current practice location address for Jennifer Stuart Grissom is 5320 Bridgers Rd Ste 4, Shallotte, NC and can be reached out via phone at 910-769-9126.

Location: 5320 Bridgers Rd Ste 4, Shallotte, NC, 28461-8302
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1659055507
Provider Name
Jennifer Stuart Grissom
Credential
Provider Entity Type
Individual
Gender
Female
Address
5320 Bridgers Rd Ste 4, Shallotte, NC, 28461-8302
Phone Number
910-769-9126
Fax Number
Provider Enumeration Date
06/12/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
5320 Bridgers Rd Ste 4
City
Shallotte
State
North Carolina
Zip
28470-4737
Phone Number
910-769-9126
Fax Number
person
Provider Business Mailing Address Details
Address
5320 Bridgers Rd Ste 4
City
Shallotte
State
North Carolina
Zip
28470-4737
Phone Number
910-769-9126
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
0704013796 (Virginia)
Definition
Definition to come...
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