IndividualActive
Candice Gronberg
NPI 1356632087 · Child Intellectual and/or Developmental Disabilities Respite Care · Lander, WY
Provider details
- NPI number
- 1356632087
- Entity type
- Individual
- Primary specialty
- Child Intellectual and/or Developmental Disabilities Respite CareRespite Care Facility
- Sex
- Female
- Sole proprietor
- Yes
- License
- 114858300 (WY)
Specialties & taxonomies
- Child Intellectual and/or Developmental Disabilities Respite CarePrimary385HR2060XLicense 114858300 (WY)
Respite Care Facility
Practice location
4 Roberts Road
Lander, WY 82520-1401
Phone: (307) 332-9122
Fax: (307) 332-9122
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 1401
Lander, WY 82520-1401
Registry dates
- Enumerated
- 2011-04-28
- Last updated
- 2011-04-28
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.