-- CANDICE RAE GRONBERG --
Individual Provider (NPI-1)
Active
Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child
Provider Information
- NPI Number
1356632087- Provider Type
- Individual Provider (NPI-1)
- Status
- Active
Contact & Location
- Address
- 4 ROBERTS ROAD, LANDER, WY, 825201401
- Phone
- (307) 332-9122
- Fax
- (307) 332-9122
Specialties & Taxonomies
Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child
Primary License: WY #114858300