MEDICARE: MS. DANA GROH LCSW

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	1041C0700X	Clinical Social Worker	55106	TX

General Provider Information

NPI Number	:	1073591749
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DANA GROH LCSW

Provider Business Mailing Address
First Line	:	8823 IMPERIAL CROSS
Second Line	:
City	:	HELOTES
State	:	TX
Zip	:	78023-3658
Country	:	US
Telephone Number	:	513-280-1954
Fax Number	:

Provider Business Practice Location Address
First Line	:	325 E SONTERRA BLVD
Second Line	:	SUITE 230
City	:	SAN ANTONIO
State	:	TX
Zip	:	78258-4054
Country	:	US
Telephone Number	:	210-439-8887
Fax Number	:	210-545-6869

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

Provider Enumeration Date	:	01/04/2006
Last Update Date	:	03/09/2015

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