MEDICARE: MOLLY GRUPE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	1590054152	WI

General Provider Information

NPI Number	:	1780511519
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MOLLY GRUPE

Provider Business Mailing Address
First Line	:	507 FROST WOODS RD
Second Line	:
City	:	MONONA
State	:	WI
Zip	:	53716-3407
Country	:	US
Telephone Number	:	507-358-2435
Fax Number	:

Provider Business Practice Location Address
First Line	:	6271 WOODLAND DR
Second Line	:
City	:	WAUNAKEE
State	:	WI
Zip	:	53597-9256
Country	:	US
Telephone Number	:	608-849-2030
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/06/2026
Last Update Date	:	05/06/2026

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Directions to “ MOLLY GRUPE ” Practice Location

Language	Start Address	Practice Location

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