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General NPI Number Information
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NPI Number | 1821180274
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Entity Type | Individual
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Provider Name | CARLA J GROH PHD APRN BC
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Gender | Female
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Dates
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Enumeration Date | 09/29/2006
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Last Update Date | 02/09/2026
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Provider Practice Location Address
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Address Line | 5555 CONNER SUITE 2691
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City | DETROIT
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State | MI
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Zip | 48213
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Country | US
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Telephone | 313-579-1182
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Fax | 313-579-5128
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Provider Business Mailing Address
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Address Line | 5555 CONNER SUITE 2691
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City | DETROIT
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State | MI
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Zip | 48213
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Country | US
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Telephone | 313-579-1182
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Fax | 313-579-5128
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 4704098802
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 364SP0809X
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Taxonomy Name | Adult Psychiatric/Mental Health Clinical Nurse Specialist
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License Number | 4704098802
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License Number State | MI
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