4th and Grove LLC
NPI #1831762228 in Glassboro, New Jersey
Provider Information
- NPI Number
- 1831762228
- Entity Type
- Organization
- Organization Name
- 4th and Grove LLC
- Primary Specialty
- Counselor - Mental Health
- Enumeration Date
- Jul 22, 2021
- Last Updated
- Jul 22, 2021
Practice Location
- Address
- 480 DEFRANCESCO CIR
- City
- Glassboro
- State
- New Jersey
- ZIP Code
- 08028-4906
- Phone
- (856) 441-5216
Authorized Official
- Name
- ROSANA GILLES-LAMONTAGNE, LPC
- Title
- OWNER
- Phone
- (856) 441-5216
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - Mental Health — Mental Health |
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