Provider Demographics
NPI:1083974927
Name:GROTE, JANET (MA CCC/SLP)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:GROTE
Suffix:
Gender:F
Credentials:MA CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4821 NE 27TH TER
Mailing Address - Street 2:
Mailing Address - City:LIGHTHOUSE POINT
Mailing Address - State:FL
Mailing Address - Zip Code:33064-7909
Mailing Address - Country:US
Mailing Address - Phone:954-420-9097
Mailing Address - Fax:
Practice Address - Street 1:4821 NE 27TH TER
Practice Address - Street 2:
Practice Address - City:LIGHTHOUSE POINT
Practice Address - State:FL
Practice Address - Zip Code:33064-7909
Practice Address - Country:US
Practice Address - Phone:954-420-9097
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-25
Last Update Date:2012-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA9538235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist