Provider Demographics
NPI:1427602580
Name:SILVA, GRACE E (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:GRACE
Middle Name:E
Last Name:SILVA
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2555 STARLING LN
Mailing Address - Street 2:
Mailing Address - City:WEST SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95691-4625
Mailing Address - Country:US
Mailing Address - Phone:916-821-5183
Mailing Address - Fax:
Practice Address - Street 1:5461 MERIDIAN MARKS RD STE 200
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-4014
Practice Address - Country:US
Practice Address - Phone:404-785-3856
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-27
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA010576235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist