Healthcare Provider Details

I. General information

NPI: 1861552580
Provider Name (Legal Business Name): BONNIE GRUSZECKI ED.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

138 OVERLOOK DR
FLORENCE MA
01062-3529
US

IV. Provider business mailing address

138 OVERLOOK DR
FLORENCE MA
01062-3529
US

V. Phone/Fax

Practice location:
  • Phone: 413-584-9280
  • Fax:
Mailing address:
  • Phone: 413-584-9280
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number4812
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number4812
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License Number4812
License Number StateMA
# 4
Primary TaxonomyN
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License Number4812
License Number StateMA
# 5
Primary TaxonomyN
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License Number4812
License Number StateMA
# 6
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number4812
License Number StateMA
# 7
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number4812
License Number StateMA
# 8
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number4812
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: