Individual
SANDRA ALI GRASTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1935 BENCH RD, VALE, OR 97918-5317
(541) 678-3238
Mailing address
1935 BENCH RD, VALE, OR 97918-5317
(541) 678-3238
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
475277486
ID
103TS0200X
School Psychologist
Primary
600210
OR
Other
Enumeration date
04/05/2022
Last updated
04/05/2022
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