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Mrs. Nicole Laray Grochow
Peer Specialist in Longview, Washington
NPI 1316589559

Nicole Laray Grochow is a Peer Specialist based in Longview, WA. Nicole Laray Grochow practices in Longview, WA. The NPI Number for Nicole Laray Grochow is 1316589559 and holds a License No. (Washington).

The current practice location address for Nicole Laray Grochow is 720 14Th Ave, Longview, WA and can be reached out via phone at 360-423-0203 and via fax at 360-577-0187.

Location: 720 14Th Ave, Longview, WA, 98632
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1316589559
Provider Name
Nicole Laray Grochow
Credential
Provider Entity Type
Individual
Gender
Female
Address
720 14Th Ave, Longview, WA, 98632
Phone Number
360-423-0203
Fax Number
360-577-0187
Provider Enumeration Date
10/09/2019
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
720 14Th Ave
City
Longview
State
Washington
Zip
98632
Phone Number
360-423-0203
Fax Number
360-577-0187
person
Provider Business Mailing Address Details
Address
720 14Th Ave
City
Longview
State
Washington
Zip
98632
Phone Number
360-423-0203
Fax Number
360-577-0187
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
(Washington)
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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