Provider Demographics
NPI:1134315187
Name:GROE, DARLA A (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:DARLA
Middle Name:A
Last Name:GROE
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:810 PENNINGTON ST
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:AR
Mailing Address - Zip Code:72745-9551
Mailing Address - Country:US
Mailing Address - Phone:479-966-7697
Mailing Address - Fax:
Practice Address - Street 1:2199 SCOTTSDALE AVE
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72764-8758
Practice Address - Country:US
Practice Address - Phone:479-750-8760
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-23
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARSP2671235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR172204795Medicaid