Individual
EMILY LYNN GROGG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
200 GLOUCESTER DR, MARTINSBURG, WV 25401-2983
(304) 407-4650
Mailing address
619 WOODS EDGE RD, FORT ASHBY, WV 26719-6912
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
C2103
WV
Other
Enumeration date
02/17/2017
Last updated
04/08/2021
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