Individual
MICHAEL GROTTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPT
Contact information
Practice address
2178 JOHNSON AVE, SAN LUIS OBISPO, CA 93401-4535
(805) 781-4711
Mailing address
3165 ALICITA CT APT B, SAN LUIS OBISPO, CA 93401-6991
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
36618
CA
167G00000X
Licensed Psychiatric Technician
Primary
36618
CA
Other
Enumeration date
07/08/2013
Last updated
10/01/2018
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