Individual
KELLI KIRSHBAUM-GROCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
527 HUMBOLDT ST, RENO, NV 89509-1603
(775) 348-4900
Mailing address
PO BOX 13092, RENO, NV 89507-3092
(775) 348-4900
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
01517-L
NV
106H00000X
Marriage & Family Therapist
Primary
MI0446
NV
Other
Enumeration date
08/21/2014
Last updated
08/21/2014
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