Healthcare Provider Details

I. General information

NPI: 1528534047
Provider Name (Legal Business Name): JODI GRABOWSKI LPA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/23/2018
Last Update Date: 10/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 WALDEN RIDGE DR STE 30
ASHEVILLE NC
28803-8598
US

IV. Provider business mailing address

7 BANNERWOOD DR
HORSE SHOE NC
28742-9709
US

V. Phone/Fax

Practice location:
  • Phone: 828-676-1657
  • Fax: 828-676-1658
Mailing address:
  • Phone: 828-242-1929
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number1896
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: