Provider Demographics
NPI:1588165401
Name:DEGROOT, EMILY (MS, ATC)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:DEGROOT
Suffix:
Gender:F
Credentials:MS, ATC
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:
Other - Last Name:HONKEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, ATC
Mailing Address - Street 1:1101 W 22ND ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-1699
Mailing Address - Country:US
Mailing Address - Phone:320-905-2430
Mailing Address - Fax:
Practice Address - Street 1:1101 W 22ND ST
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-1699
Practice Address - Country:US
Practice Address - Phone:320-905-2430
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-26
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD05492255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer