Individual
ISABELLA GROGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, BCBA
Contact information
Practice address
551 36TH ST SE, GRAND RAPIDS, MI 49548-2355
(844) 503-1848
Mailing address
1500 S DOUGLAS RD STE 230, CORAL GABLES, FL 33134-4108
(844) 244-1818
(888) 512-0733
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
MI
103K00000X
Behavior Analyst
Primary
—
MI
103K00000X
Behavior Analyst
—
—
106S00000X
Behavior Technician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BACB747538
BACB IDENTIFICATION NUMBER
MI
Enumeration date
02/07/2020
Last updated
10/09/2024
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