Provider Demographics
NPI:1578088506
Name:GROSSO, VALERIE (RDN)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:
Last Name:GROSSO
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6501 E GREENWAY PKWY STE 103-195
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-2025
Mailing Address - Country:US
Mailing Address - Phone:602-430-8495
Mailing Address - Fax:
Practice Address - Street 1:5350 E MARILYN RD
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-2346
Practice Address - Country:US
Practice Address - Phone:602-430-8405
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-10
Last Update Date:2018-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1030300133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered