Provider Demographics
NPI:1316013097
Name:GRIMALDI, MEGAN ELIZABETH (MS, CCC,SLP,L)
Entity Type:Individual
Prefix:MS
First Name:MEGAN
Middle Name:ELIZABETH
Last Name:GRIMALDI
Suffix:
Gender:F
Credentials:MS, CCC,SLP,L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14014 EMERSON CT
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60544-6079
Mailing Address - Country:US
Mailing Address - Phone:815-210-9311
Mailing Address - Fax:815-886-9072
Practice Address - Street 1:14014 EMERSON CT
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60544-6079
Practice Address - Country:US
Practice Address - Phone:815-210-9311
Practice Address - Fax:815-886-9072
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist