Healthcare Provider Details

I. General information

NPI: 1285745737
Provider Name (Legal Business Name): RHEA M GROVER EFDA, PTDA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 04/25/2025
Certification Date: 04/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14629 W OBERLIN WAY
SURPRISE AZ
85387-6747
US

IV. Provider business mailing address

14629 W OBERLIN WAY
SURPRISE AZ
85387-6747
US

V. Phone/Fax

Practice location:
  • Phone: 623-760-5230
  • Fax:
Mailing address:
  • Phone: 623-760-5230
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code126800000X
TaxonomyDental Assistant
License Number126800000X3
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC19140
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: