Individual
GRAYDON E. ESTABROOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D. SCHOOL PSYCH
Contact information
Practice address
315 E NORTH DR, BLOOMINGTON, IN 47401-6595
(812) 330-7700
Mailing address
315 E NORTH DR, BLOOMINGTON, IN 47401-6595
(812) 330-7700
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
663394
IN
Other
Enumeration date
11/06/2024
Last updated
11/06/2024
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