Healthcare Provider Details

I. General information

NPI: 1306031273
Provider Name (Legal Business Name): COURTENAY ELIZABETH GRABOWSKI LM, LA, CBE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/12/2007
Last Update Date: 09/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3034 MONTCLAIR DR
CLARKSTON MI
48348-5066
US

IV. Provider business mailing address

3034 MONTCLAIR DR
CLARKSTON MI
48348-5066
US

V. Phone/Fax

Practice location:
  • Phone: 248-396-5132
  • Fax:
Mailing address:
  • Phone: 248-396-5132
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175M00000X
TaxonomyLay Midwife
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: