Individual
MRS. STACEY LYNNE GRODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CTRS
Contact information
Practice address
1490 EAST BELTLINE AVE SE, GRAND RAPIDS, MI 49506
(616) 940-0040
Mailing address
1490 EAST BELTLINE AVE SE, GRAND RAPIDS, MI 49506
(616) 940-0040
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
45840
MI
Other
Enumeration date
01/17/2017
Last updated
11/04/2020
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