| Karen Grumme Rodriguez Llc | |
|
26 E Meadow St Ste 14 Fayetteville AR 72701-5357 | |
| (479) 408-3331 | |
| Not Available |
| Full Name | Karen Grumme Rodriguez Llc |
|---|---|
| Speciality | Social Worker |
| Location | 26 E Meadow St Ste 14, Fayetteville, Arkansas |
| Authorized Official Name and Position | Karen Jean Grumme Rodriguez (THERAPIST) |
| Authorized Official Contact | 4794083331 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Karen Grumme Rodriguez Llc 3755 Laural Rdg Springdale AR 72764-1086 Ph: (704) 301-4174 | Karen Grumme Rodriguez Llc 26 E Meadow St Ste 14 Fayetteville AR 72701-5357 Ph: (479) 408-3331 |
| NPI Number | 1558015164 |
|---|---|
| Provider Enumeration Date | 02/11/2022 |
| Last Update Date | 02/11/2022 |
| Certification Date | 02/11/2022 |
| Medicare PECOS PAC ID | 8325434632 |
|---|---|
| Medicare Enrollment ID | O20220413000042 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558015164 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Karen Jean Grumme Rodriguez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811562515 PECOS PAC ID: 9234525544 Enrollment ID: I20220413000067 |
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