Healthcare Provider Details

I. General information

NPI: 1952030413
Provider Name (Legal Business Name): YARONE GRABINER PSYD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2022
Last Update Date: 07/19/2026
Certification Date: 07/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 SUPERIOR AVE
WASHBURN WI
54891-9426
US

IV. Provider business mailing address

1401 FUR FARM RD
WASHBURN WI
54891-4554
US

V. Phone/Fax

Practice location:
  • Phone: 715-209-0998
  • Fax:
Mailing address:
  • Phone: 715-209-0998
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number554857
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: