Individual
MICHELLE GRODE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, OTR/L
Contact information
Practice address
2200 HAVASUPAI BLVD, LAKE HAVASU CITY, AZ 86403-3122
(605) 366-8790
Mailing address
837 N COLUMBIA DR, SIOUX FALLS, SD 57103-6606
(605) 366-8790
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
056.008353
IL
225X00000X
Occupational Therapist
Primary
0784
SD
225X00000X
Occupational Therapist
4391
AZ
Other
Enumeration date
08/17/2009
Last updated
11/02/2010
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