Individual
DR. RANDY H GRODI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
750 S MONROE ST, MONROE, MI 48161-1433
(734) 639-2262
(734) 264-4114
Mailing address
750 S MONROE ST, MONROE, MI 48161-1433
(734) 639-2262
(734) 264-4114
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301007925
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0E84509
BLUE CROSS PROVIDER ID
MI
Enumeration date
03/13/2007
Last updated
03/29/2016
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