Provider Demographics
NPI:1598098352
Name:GRONSETH, KRISTY INEZ (OTR/L, CDRS)
Entity Type:Individual
Prefix:MRS
First Name:KRISTY
Middle Name:INEZ
Last Name:GRONSETH
Suffix:
Gender:F
Credentials:OTR/L, CDRS
Other - Prefix:MISS
Other - First Name:KRISTY
Other - Middle Name:INEZ
Other - Last Name:SCHWARTZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:7508 DEERFIELD RD NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87120-4530
Mailing Address - Country:US
Mailing Address - Phone:865-659-3112
Mailing Address - Fax:505-727-9296
Practice Address - Street 1:505 ELM ST.
Practice Address - Street 2:LOVELACE REHABILITATION HOSPITAL
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87102
Practice Address - Country:US
Practice Address - Phone:505-229-0319
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-11
Last Update Date:2021-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM2609225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist