Provider Demographics
NPI:1053714873
Name:GROBLEWSKI, TONJIA (M ED)
Entity type:Individual
Prefix:
First Name:TONJIA
Middle Name:
Last Name:GROBLEWSKI
Suffix:
Gender:F
Credentials:M ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 BOUCHILLION DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-6182
Mailing Address - Country:US
Mailing Address - Phone:864-320-8112
Mailing Address - Fax:
Practice Address - Street 1:212 BOUCHILLION DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-6182
Practice Address - Country:US
Practice Address - Phone:864-320-8112
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-07
Last Update Date:2014-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC269235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist