Basic Information
| Provider Information | |||||||||
| NPI: | 1750778544 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GROON | ||||||||
| FirstName: | KATHERINE | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | AU.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1925 MOUNTAIN VIEW AVE | ||||||||
| Address2: | |||||||||
| City: | LONGMONT | ||||||||
| State: | CO | ||||||||
| PostalCode: | 805013128 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7204943120 | ||||||||
| FaxNumber: | 7204943107 | ||||||||
| Practice Location | |||||||||
| Address1: | 100 COOK ST STE 304 | ||||||||
| Address2: | |||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802065339 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7208482820 | ||||||||
| FaxNumber: | 7204943107 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/20/2015 | ||||||||
| LastUpdateDate: | 08/14/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 08/14/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 231H00000X | AUD.0000796 | CO | Y | Speech, Language and Hearing Service Providers | Audiologist |
No ID Information.