Provider Demographics
NPI:1013296045
Name:GROFF, PATRICIA (PHD)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:
Last Name:GROFF
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:TRICIA
Other - Middle Name:
Other - Last Name:GROFF
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:11 E BELL RD
Mailing Address - Street 2:APT 330
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85022-2306
Mailing Address - Country:US
Mailing Address - Phone:717-598-5674
Mailing Address - Fax:
Practice Address - Street 1:1717 E BELL RD
Practice Address - Street 2:SUITE 9
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85022-6200
Practice Address - Country:US
Practice Address - Phone:480-382-0383
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-08
Last Update Date:2013-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4428103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist