Organization Name: | GRANT SPEECH PATHOLOGY SERVICES, LLC |
NPI Number: | 1255682050 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TAMISHA R GRANT (OWNER/SPEECH-LANGUAGE PATHOLOGIST) |
Mailing Address: | 7133 Britens Way Brandywine |
State: | MD US |
Postal Code: | 206136264 |
Phone Number: | 2403206356 |
Fax Number: | 3017821974 |
NPI Enumeration Date: | 09/20/2012 |
NPI Last Update Date: | 09/20/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 05820 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MD |
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 |