| Mallory Grimste, Lcsw | |
|
30 Hazel Ter Ste 12 Woodbridge CT 06525-2240 | |
| (203) 228-8971 | |
| (203) 429-8628 |
| Full Name | Mallory Grimste, Lcsw |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 30 Hazel Ter Ste 12, Woodbridge, Connecticut |
| Authorized Official Name and Position | Mallory Grimste (OWNER) |
| Authorized Official Contact | 2032288971 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mallory Grimste, Lcsw 30 Hazel Ter Ste 12 Woodbridge CT 06525-2240 Ph: (203) 228-8971 | Mallory Grimste, Lcsw 30 Hazel Ter Ste 12 Woodbridge CT 06525-2240 Ph: (203) 228-8971 |
| NPI Number | 1417444910 |
|---|---|
| Provider Enumeration Date | 04/19/2018 |
| Last Update Date | 04/19/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417444910 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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