Individual
SALLY J GROSSCUP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1210 PEARL ST, EUGENE, OR 97401-3573
(541) 343-2663
(541) 343-2663
Mailing address
1210 PEARL ST, EUGENE, OR 97401-3573
(541) 343-2663
(541) 343-2663
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
658
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
162859
OREGON GEPT OF HUMAN RES.
OR
05
—
162859
—
OR
Enumeration date
09/17/2006
Last updated
08/17/2022
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