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General NPI Number Information
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NPI Number | 1386931731
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Entity Type | Individual
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Provider Name | MISTY GROSCHKE SLP
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Gender | Female
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Dates
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Enumeration Date | 07/06/2011
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Last Update Date | 08/29/2022
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Provider Practice Location Address
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Address Line | 801 S ELLIS ST
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City | GROESBECK
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State | TX
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Zip | 76642-1857
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Country | US
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Telephone | 254-729-4197
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Fax |
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Provider Business Mailing Address
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Address Line | 1132 E LAKE CREEK RD
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City | RIESEL
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State | TX
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Zip | 76682-2600
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Country | US
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Telephone | 254-292-8777
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 102987
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License Number State | TX
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