Individual provider · Type 1 NPI
Candice Rae Gronberg
Child Intellectual and/or Developmental Disabilities Respite Care · Lander, WY
Practice location
4 Roberts Road
Lander, WY 82520-1401
Fax (307) 332-9122
Mailing address
PO Box 1401, 4 Roberts Road
Lander, WY 82520-1401
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Child Intellectual and/or Developmental Disabilities Respite Care Primary | 385HR2060X | 114858300 (WY) |
Child Intellectual and/or Developmental Disabilities Respite Care: A facility or distinct part of a facility that provides short term, residential care to children diagnosed with intellectual and/or developmental disabilities as respite for the regular caregivers.
About NPI 1356632087
Candice Rae Gronberg's National Provider Identifier is 1356632087, issued on Apr 28, 2011. The primary taxonomy on file is Child Intellectual and/or Developmental Disabilities Respite Care (385HR2060X), and the practice location is in Lander, WY. The record was last updated on Apr 28, 2011.