Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | PA018266 | PA |
Y | 103T00000X | Psychologist | PA018266 | PA |
NPI | 1013444306 |
---|---|
Provider Name | Dr. Gabriela Grosser |
First Address | Philadelphia, PA 19146-1924 |
Second Address | Philadelphia, PA 19147-1582 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2017 |
Last Update Date | 17/05/2017 |