Provider Demographics
NPI:1336109339
Name:GROVES, DEBBIE K (MACCC)
Entity Type:Individual
Prefix:MRS
First Name:DEBBIE
Middle Name:K
Last Name:GROVES
Suffix:
Gender:F
Credentials:MACCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9903 JAMESBURG ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67212-6737
Mailing Address - Country:US
Mailing Address - Phone:316-721-4238
Mailing Address - Fax:316-721-0576
Practice Address - Street 1:9903 JAMESBURG ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67212-6737
Practice Address - Country:US
Practice Address - Phone:316-721-4238
Practice Address - Fax:316-721-0576
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS00029235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist