Organization
GRIDLEY BEHAVIORAL HEALTHCARE, P.A.
Active
Organization
GRIDLEY BEHAVIORAL HEALTHCARE, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GREGORY CHARLES GRIDLEY PH.D. (PRESIDENT)
(252) 522-3976
Entity
Organization
Contact information
Practice address
2100B N HERRITAGE ST, KINSTON, NC 28501-2222
(252) 522-3976
(252) 522-1582
Mailing address
2100B N. HERRITAGE STREET, KINSTON, NC 28501-2222
(252) 522-3976
(252) 522-1582
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1141
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6000369
—
NC
Enumeration date
02/23/2006
Last updated
11/06/2007
Update your record
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