Provider Demographics
NPI:1891572947
Name:GROTH, DANIELLE A
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:A
Last Name:GROTH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7410 BOYNTON BEACH BLVD STE B1
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33437-6157
Mailing Address - Country:US
Mailing Address - Phone:561-223-1650
Mailing Address - Fax:
Practice Address - Street 1:7410 BOYNTON BEACH BLVD STE B1
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437-6157
Practice Address - Country:US
Practice Address - Phone:561-223-1650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-12
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician