Doctor Name: | MR. WILLIAM ALBERT GRIMBERG |
NPI Number: | 1083847388 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LMHC |
License Number: | LH00004107 |
Business Practice Address: | 300 Ocean Ave Raymond, WA - 985773016 |
Business Phone Number: | 3609422303 |
Business Fax Number: | 3609425312 |
Mailing Address: | 2204 Pacific Ave N, LONG BEACH |
State: | WA |
Postal Code: | 986313300 |
Phone Number: | 3609422303 |
Fax Number: | 3609425312 |
NPI Enumeration Date: | 09/02/2009 |
NPI Last Update Date: | 09/02/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | LH00004107 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |