Provider Demographics
NPI:1093079667
Name:GRANDBOIS THERAPY AND CONSULTING, LLC
Entity Type:Organization
Organization Name:GRANDBOIS THERAPY AND CONSULTING, LLC
Other - Org Name:GREATER BOSTON SPEECH AND LANGUAGE THERAPY, PLLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER/MANAGING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KATHARINE
Authorized Official - Middle Name:B
Authorized Official - Last Name:GRANDBOIS
Authorized Official - Suffix:
Authorized Official - Credentials:CCC-SLP
Authorized Official - Phone:978-254-1002
Mailing Address - Street 1:110 HARTWELL AVE SUITE 350
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02421
Mailing Address - Country:US
Mailing Address - Phone:978-254-1002
Mailing Address - Fax:978-274-7558
Practice Address - Street 1:110 HARTWELL AVE SUITE 350
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02421
Practice Address - Country:US
Practice Address - Phone:978-254-1002
Practice Address - Fax:978-274-7558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-28
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MASP-7391-SL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty