Healthcare Provider Details

I. General information

NPI: 1326026352
Provider Name (Legal Business Name): CANDICE LORRAINE GROTSKY AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2006
Last Update Date: 04/25/2026
Certification Date: 04/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13934 N 59TH AVE STE 120
GLENDALE AZ
85306-4168
US

IV. Provider business mailing address

13934 N 59TH AVE
GLENDALE AZ
85306-4167
US

V. Phone/Fax

Practice location:
  • Phone: 602-654-3383
  • Fax: 602-547-9644
Mailing address:
  • Phone: 602-654-3383
  • Fax: 602-547-9644

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberDA1759
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: