Individual
DR. KIRSTIN GROS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
109 BEE ST, RALPH H JOHNSON VAMC, MENTAL HEALTH SERVICE LINE 116, CHARLESTON, SC 29401-5703
(843) 577-5011
Mailing address
109 BEE ST, RALPH H JOHNSON VAMC, MENTAL HEALTH SERVICE LINE 116, CHARLESTON, SC 29401-5703
(843) 577-5011
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
—
—
103TF0000X
Family Psychologist
—
—
103TM1800X
Intellectual & Developmental Disabilities Psychologist
—
—
103TP2701X
Group Psychotherapy Psychologist
—
—
Other
Enumeration date
10/06/2011
Last updated
09/09/2015
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