Provider Demographics
NPI:1235393414
Name:GRADY, JOAN GROSSMAN (MA, CCC-SP)
Entity Type:Individual
Prefix:MS
First Name:JOAN
Middle Name:GROSSMAN
Last Name:GRADY
Suffix:
Gender:F
Credentials:MA, CCC-SP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 727
Mailing Address - Street 2:
Mailing Address - City:PLEASANT VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:12569-0727
Mailing Address - Country:US
Mailing Address - Phone:845-728-4200
Mailing Address - Fax:
Practice Address - Street 1:121 WESTMORELAND AVE
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10606-2323
Practice Address - Country:US
Practice Address - Phone:914-963-1600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-16
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000471-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist