Doctor Name: | DIANE MARIE GRINAGE |
NPI Number: | 1962645721 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A., M.S. - CCC/SLP |
License Number: | 2202005089 |
Business Practice Address: | 3750 Old Lee Highway Fairfax, VA - 22030 |
Business Phone Number: | 7032467194 |
Business Fax Number: | |
Mailing Address: | 8622 Blackpool Dr, ANNANDALE |
State: | VA |
Postal Code: | 220034315 |
Phone Number: | 7037648222 |
Fax Number: | |
NPI Enumeration Date: | 04/09/2009 |
NPI Last Update Date: | 04/09/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 2202005089 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
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 |