Grizzard, Jennifer Benson

Grizzard, Jennifer Benson is an sole proprietor health care provider with primary practice located at 514 W Bankhead Hwy Suite 100, Villa Rica GA 30180-1736. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Grizzard, Jennifer Benson can be contacted via phone (678) 941-3868.

Contact Information

Primary practice address
514 W Bankhead Hwy Suite 100 Villa Rica GA 30180-1736
Phone: (678) 941-3868
Fax: (678) 941-3217
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X LPC004238 Georgia

Profile Details

NPI number 1336344456
LBN Legal business name Grizzard, Jennifer Benson
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 19th, 2007
Last updated Jun 9th, 2015 - about 9 years ago

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 1336344456 NPPES
Georgia MEDICAID 839556035B

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