Provider Demographics
NPI:1417360553
Name:GRIEGER, STACY (M A CCC/SLP)
Entity Type:Individual
Prefix:MRS
First Name:STACY
Middle Name:
Last Name:GRIEGER
Suffix:
Gender:F
Credentials:M A CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 E OAK ST
Mailing Address - Street 2:
Mailing Address - City:OAK HARBOR
Mailing Address - State:OH
Mailing Address - Zip Code:43449-1463
Mailing Address - Country:US
Mailing Address - Phone:419-707-0951
Mailing Address - Fax:
Practice Address - Street 1:108 E OAK ST
Practice Address - Street 2:
Practice Address - City:OAK HARBOR
Practice Address - State:OH
Practice Address - Zip Code:43449-1463
Practice Address - Country:US
Practice Address - Phone:419-707-0951
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-06
Last Update Date:2014-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP7701235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist