Provider Demographics
NPI:1447481734
Name:KENDALL GROVE, KWAI (PHD)
Entity type:Individual
Prefix:DR
First Name:KWAI
Middle Name:
Last Name:KENDALL GROVE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2305 E ARAPAHOE RD
Mailing Address - Street 2:SUITE 149
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80122-1522
Mailing Address - Country:US
Mailing Address - Phone:303-662-9670
Mailing Address - Fax:303-730-2838
Practice Address - Street 1:2305 E ARAPAHOE RD
Practice Address - Street 2:SUITE 149
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80122-1522
Practice Address - Country:US
Practice Address - Phone:303-662-9670
Practice Address - Fax:303-730-2838
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-04
Last Update Date:2009-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2321103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent