Individual
MRS. NICOLE CHRISTINE GROSKREUTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSED, BCBA
Contact information
Practice address
521 ROCKWOOD CIR, PROVIDENCE, UT 84332-9477
(508) 423-1007
Mailing address
521 ROCKWOOD CIR, PROVIDENCE, UT 84332-9477
(508) 423-1007
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
Primary
1-05-2248
MA
Other
Enumeration date
09/16/2008
Last updated
09/16/2008
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