Doctor Name: | DR. ELIZABETH G GREVEY |
NPI Number: | 1154652444 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PSYD, BCBA |
License Number: | PY 60058662 |
Business Practice Address: | 13709 Twin Lakes Dr E Graham, WA - 983387574 |
Business Phone Number: | 2533184648 |
Business Fax Number: | 3608795108 |
Mailing Address: | Po Box 14, GRAHAM |
State: | WA |
Postal Code: | 983380014 |
Phone Number: | 2533184648 |
Fax Number: | 3608795108 |
NPI Enumeration Date: | 01/26/2010 |
NPI Last Update Date: | 01/26/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | PY 60058662 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |