Individual
DYLAN GRIEVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2225 CHALLENGER WAY, SANTA ROSA, CA 95407-5441
(707) 576-8181
Mailing address
59 SWITZERLAND RD, LEWISTON, ME 04240-5161
(773) 712-1126
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
95146187
CA
Other
Enumeration date
06/28/2018
Last updated
06/28/2018
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