Provider Demographics
NPI:1417150046
Name:DENTON, GRETCHEN MERRITT (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:GRETCHEN
Middle Name:MERRITT
Last Name:DENTON
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 SIENNA DR
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28716-9503
Mailing Address - Country:US
Mailing Address - Phone:828-646-9089
Mailing Address - Fax:
Practice Address - Street 1:99 SIENNA DR
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:NC
Practice Address - Zip Code:28716-9503
Practice Address - Country:US
Practice Address - Phone:828-646-9089
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4228235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist