Provider Demographics
NPI:1346556487
Name:CRAM, GRACE ELAINE (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:GRACE
Middle Name:ELAINE
Last Name:CRAM
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NORTH ANSON
Mailing Address - State:ME
Mailing Address - Zip Code:04958-7511
Mailing Address - Country:US
Mailing Address - Phone:207-431-3918
Mailing Address - Fax:
Practice Address - Street 1:56 N MAIN ST
Practice Address - Street 2:
Practice Address - City:NORTH ANSON
Practice Address - State:ME
Practice Address - Zip Code:04958-7511
Practice Address - Country:US
Practice Address - Phone:207-431-3918
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-26
Last Update Date:2010-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MESP1613235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist