Provider Demographics
NPI:1235444803
Name:GRAN, LAURA CHRISTINE (MA, MED, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:CHRISTINE
Last Name:GRAN
Suffix:
Gender:F
Credentials:MA, MED, CCC-SLP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:5920 WILCOX PL
Mailing Address - Street 2:SUITE E
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-6802
Mailing Address - Country:US
Mailing Address - Phone:614-792-2252
Mailing Address - Fax:614-791-2600
Practice Address - Street 1:5920 WILCOX PL
Practice Address - Street 2:SUITE E
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43016-6802
Practice Address - Country:US
Practice Address - Phone:614-792-2252
Practice Address - Fax:614-791-2600
Is Sole Proprietor?:No
Enumeration Date:2010-08-08
Last Update Date:2010-08-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH4882235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist