Healthcare Provider Details

I. General information

NPI: 1447222997
Provider Name (Legal Business Name): CONNIE DENISE GRABER PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2006
Last Update Date: 04/10/2025
Certification Date: 04/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 DOUGLAS PIKE STE 220
SMITHFIELD RI
02917-1879
US

IV. Provider business mailing address

4800 N SCOTTSDALE RD STE 2500
SCOTTSDALE AZ
85251-7630
US

V. Phone/Fax

Practice location:
  • Phone: 401-785-0040
  • Fax: 401-941-7847
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number396
License Number StateSD
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPS02334
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: