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Individual

MRS. MARILYN JEAN GROOT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.A.

Contact information

Practice address
2520 HONOLULU AVE, SUITE 180, MONTROSE, CA 91020-1853
(818) 248-8648
(818) 248-7928
Mailing address
2520 HONOLULU AVE, SUITE 180, MONTROSE, CA 91020-1853
(818) 248-8648
(818) 248-7928

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
AU1624
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
AU0016240
CA
Enumeration date
07/18/2006
Last updated
07/08/2007
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