Grinnage, Deaetta

Grinnage, Deaetta is an individual health care provider with primary practice located at 299 Cooper Rd Ste B , Loganville GA 30052-2579. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Grinnage, Deaetta can be contacted via phone (770) 217-4336.

Contact Information

Primary practice address
299 Cooper Rd Ste B Loganville GA 30052-2579
Phone: (770) 217-4336
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X LPC013200 Georgia

Profile Details

NPI number 1548822398
LBN Legal business name Grinnage, Deaetta
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 2nd, 2019
Last updated Jan 6th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1548822398 NPPES
Georgia Other LPC013200 PROFESSIONAL COUNSELOR LICENSE

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