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Individual

DR. DENISE K. GROSS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PSY.D.

Contact information

Practice address
6015 111TH ST E, BRADENTON, FL 34211-9468
(941) 756-0292
(941) 756-0161
Mailing address
6015 111TH ST E, BRADENTON, FL 34211-9468
(941) 756-0292
(941) 756-0161

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PY0004484
FL
103T00000X
Psychologist
PY0004484
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
211652900
FL
Enumeration date
07/11/2006
Last updated
04/13/2009
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