MRS. Nicole Laray Grochow

NPI #1316589559 in Longview, Washington

Provider Information

NPI Number: 1316589559
Entity Type: Individual
Name: MRS. Nicole Laray Grochow
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Peer Specialist
Enumeration Date: Oct 9, 2019
Last Updated: Sep 7, 2021

Practice Location

Address: 720 14TH AVE
City: Longview
State: Washington
ZIP Code: 98632
Phone: (360) 423-0203

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Peer Specialist	175T00000X	Primary

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