| NPI | 1205053154 |
|---|---|
| Former Name | ROBERT LOUIS GROSS |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WV 1078) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 8449) |
| 103TC0700X Psychologist, Clinical (Licence: OH 6331) | |
| 103TC0700X Psychologist, Clinical (Licence: WV 1078) | |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2017-10-31 |