Whalio Doctors

NPI 1356632087

Candice Rae Gronberg

Practitioner Child Intellectual and/or Developmental Disabilities Respite Care Lander, WY

Practice location

Address
4 Roberts Road, Lander, WY 82520-1401
Phone
(307) 332-9122
Fax
(307) 332-9122
Mailing address
PO Box 1401 4 Roberts Road, Lander, WY 82520-1401

Registered specialties

Child Intellectual and/or Developmental Disabilities Respite Care Primary
Respite Care Facility Taxonomy 385HR2060X Licence 114858300 (WY)

Registry record

NPI
1356632087
Entity type
Individual
Sex (as registered)
Female
NPI issued
28 Apr 2011
Record last updated
28 Apr 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.