Individual
DR. IRWIN GROSSMAN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
5757 W THUNDERBIRD RD, W-401, GLENDALE, AZ 85306-4641
(602) 439-0475
(602) 439-0106
Mailing address
5757 W THUNDERBIRD RD, W-401, GLENDALE, AZ 85306-4641
(602) 439-0475
(602) 439-0106
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1302
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AZ0621030
BC/BS ID
AZ
Enumeration date
04/21/2006
Last updated
07/08/2007
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