Provider Demographics
NPI:1215190038
Name:BINOTTI, GRAYSON VERNER (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:GRAYSON
Middle Name:VERNER
Last Name:BINOTTI
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:GRAYSON
Other - Middle Name:VERNER
Other - Last Name:ADAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:PO DRAWER 2109
Mailing Address - Street 2:
Mailing Address - City:RUSSELLVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72811
Mailing Address - Country:US
Mailing Address - Phone:429-967-2322
Mailing Address - Fax:479-967-2876
Practice Address - Street 1:5701 SPRINGHILL ROAD
Practice Address - Street 2:
Practice Address - City:BENTON
Practice Address - State:AR
Practice Address - Zip Code:72015-0000
Practice Address - Country:US
Practice Address - Phone:501-653-2255
Practice Address - Fax:501-653-2257
Is Sole Proprietor?:No
Enumeration Date:2008-07-02
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR168955721Medicaid