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Individual
MR. ROBERT BRADY GRIDER
Active
Individual
MR. ROBERT BRADY GRIDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS/CCC-SP
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
5042
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05995GR
BLUE CROSS BLUE SHIELD
MN
01
—
134612
CHOICE PLUS/PATIENT CHOIC
MN
05
—
334245000
—
MN
01
—
46000002
MEDICA CHOICE
MN
01
—
64601000
MEDICA CHOICE
MN
Enumeration date
09/21/2006
Last updated
08/19/2022
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