Provider Demographics
NPI:1538505813
Name:GROSSO, LAURA MARIE (BA, MS, NCC)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:MARIE
Last Name:GROSSO
Suffix:
Gender:F
Credentials:BA, MS, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 COURT ST
Mailing Address - Street 2:SUITE 42, COB
Mailing Address - City:NORWICH
Mailing Address - State:NY
Mailing Address - Zip Code:13815-1695
Mailing Address - Country:US
Mailing Address - Phone:607-337-1800
Mailing Address - Fax:607-336-1474
Practice Address - Street 1:5 COURT ST
Practice Address - Street 2:SUITE 42, COB
Practice Address - City:NORWICH
Practice Address - State:NY
Practice Address - Zip Code:13815-1695
Practice Address - Country:US
Practice Address - Phone:607-337-1800
Practice Address - Fax:607-336-1474
Is Sole Proprietor?:No
Enumeration Date:2013-05-14
Last Update Date:2013-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor