Individual
JARED TIMOTHY GROH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, CCC-SLP
Contact information
Practice address
1202 WEISS ST, SAGINAW, MI 48602-5471
(989) 754-1419
Mailing address
1202 WEISS ST, SAGINAW, MI 48602-5471
(989) 754-1419
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7101000777
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1215939491
—
MI
Enumeration date
04/23/2018
Last updated
04/23/2018
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