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General NPI Number Information
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NPI Number | 1114209467
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Entity Type | Individual
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Provider Name | MS. CAROL GROSS
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Gender | Female
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Dates
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Enumeration Date | 09/13/2011
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Last Update Date | 09/13/2011
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Provider Practice Location Address
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Address Line | 5524 S PRINCE ST
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City | LITTLETON
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State | CO
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Zip | 80120-1126
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Country | US
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Telephone | 303-761-7991
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Fax |
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Provider Business Mailing Address
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Address Line | 6671 W FROST AVE
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City | LITTLETON
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State | CO
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Zip | 80128-4508
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Country | US
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Telephone | 303-973-9798
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 0389840 TEACHER
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 0389840 TEACHER
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License Number State | CO
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