Provider Demographics
NPI:1881945806
Name:GROFF, DEBRA
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:
Last Name:GROFF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DEBRA
Other - Middle Name:
Other - Last Name:GORSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11825 MAGNOLIA BLVD APT 219
Mailing Address - Street 2:
Mailing Address - City:VALLEY VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91607-2879
Mailing Address - Country:US
Mailing Address - Phone:818-744-2055
Mailing Address - Fax:
Practice Address - Street 1:11825 MAGNOLIA BLVD APT 219
Practice Address - Street 2:
Practice Address - City:VALLEY VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91607-2879
Practice Address - Country:US
Practice Address - Phone:818-744-2055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-01
Last Update Date:2012-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist