Individual
GRANT N NEWBOLD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
904 E 25TH ST, KEARNEY, NE 68847-4603
(308) 830-3070
Mailing address
1650 32 RD, MINDEN, NE 68959-6612
(308) 830-3070
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
582
NE
Other
Enumeration date
08/30/2006
Last updated
08/21/2014
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