Individual
LUCILLE GROUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
22104 RHODODENDRON LN NW, POULSBO, WA 98370-9406
(360) 779-8990
Mailing address
22104 RHODODENDRON LN NW, POULSBO, WA 98370-9406
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
LL 00001438
WA
Other
Enumeration date
12/18/2012
Last updated
12/18/2012
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