Provider Demographics
NPI:1215174974
Name:GROTHE, ELIZABETH ANN (MA SPEECH)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:ANN
Last Name:GROTHE
Suffix:
Gender:F
Credentials:MA SPEECH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4300 GRAVOIS RD
Mailing Address - Street 2:
Mailing Address - City:HOUSE SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:63051-2304
Mailing Address - Country:US
Mailing Address - Phone:636-671-3470
Mailing Address - Fax:
Practice Address - Street 1:2843 COMMUNITY LN
Practice Address - Street 2:
Practice Address - City:HIGH RIDGE
Practice Address - State:MO
Practice Address - Zip Code:63049-2337
Practice Address - Country:US
Practice Address - Phone:636-677-3473
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-16
Last Update Date:2009-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist