| Grassroots Therapy Group Llc | |
|
2167 Rebecca Cir Montgomery IL 60538-5008 | |
| (630) 803-4847 | |
| Not Available |
| Full Name | Grassroots Therapy Group Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 2167 Rebecca Cir, Montgomery, Illinois |
| Authorized Official Name and Position | Jaclyn Harwey (OWNER/THERAPIST) |
| Authorized Official Contact | 6308034847 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Grassroots Therapy Group Llc 2167 Rebecca Cir Montgomery IL 60538-5008 Ph: (630) 803-4847 | Grassroots Therapy Group Llc 2167 Rebecca Cir Montgomery IL 60538-5008 Ph: (630) 803-4847 |
| NPI Number | 1245982461 |
|---|---|
| Provider Enumeration Date | 01/19/2022 |
| Last Update Date | 01/19/2022 |
| Certification Date | 01/19/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245982461 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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