Individual
ANDREA GROCHOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
245 NORTH ST, BRISTOL, VA 24201-3274
(276) 669-4711
Mailing address
245 NORTH ST, BRISTOL, VA 24201-3274
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202006924
VA
235Z00000X
Speech-Language Pathologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2202006924
VA SLP LICENSE
VA
01
—
4779
TN SLP LICENSE
TN
Enumeration date
03/11/2019
Last updated
03/11/2019
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