Individual
ELIZABETH GROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5200 W CEDAR HILLS DR, DUNLAP, IL 61525-9127
(309) 243-8655
Mailing address
5200 W CEDAR HILLS DR, DUNLAP, IL 61525-9127
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
2537213
IL
Other
Enumeration date
01/06/2015
Last updated
01/06/2015
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