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Contact Information

MARYAM M GRIMWOOD, LPC
112 W CENTER ST
FAYETTEVILLE, AR72701-6073
 Phone: 479-316-7770
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Mental Health

101YM0800X
 

Genetic Counselor, MS

170300000X
Indicates primary specialty

NPI Profile & details for MARYAM M GRIMWOOD · (Female)

NPI # 1437190360
Status Active
Credentials LPC (Licensed Professional Counselor)
Entity Individual
Enumeration date 06/10/2006
Last updated 02/06/2019 - About 7 years ago
Sole proprietor 1 No
Identifiers
  • AR License # A1109095
  • AR License # P1804043
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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