| Doctor Name: | MRS. ELIZABETH JANE O'GRADY |
| NPI Number: | 1043312663 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MS CCC-SLP |
| License Number: | SA5968 |
| Business Practice Address: | 11512 Lake Mead Ave Suite 203 Jacksonville, FL - 322569680 |
| Business Phone Number: | 9046525408 |
| Business Fax Number: | 9049976478 |
| Mailing Address: | 7955 Mount Ranier Dr, JACKSONVILLE |
| State: | FL |
| Postal Code: | 322562906 |
| Phone Number: | 9046525408 |
| Fax Number: | 9049976478 |
| NPI Enumeration Date: | 09/03/2006 |
| NPI Last Update Date: | 09/29/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | SA5968 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |