Provider Demographics
NPI:1457236440
Name:GRODER, CECILE REILEY
Entity type:Individual
Prefix:
First Name:CECILE
Middle Name:REILEY
Last Name:GRODER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 LONGMEADOW DR
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01952-2508
Mailing Address - Country:US
Mailing Address - Phone:978-360-1545
Mailing Address - Fax:
Practice Address - Street 1:5 LONGMEADOW DR
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MA
Practice Address - Zip Code:01952-2508
Practice Address - Country:US
Practice Address - Phone:978-360-1545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-08
Last Update Date:2025-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental TherapistGroup - Single Specialty