Provider Demographics
NPI:1467704635
Name:GRAMES, LYNN MARTY (MA, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:LYNN
Middle Name:MARTY
Last Name:GRAMES
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 1:1 CHILDRENS PL
Mailing Address - Street 2:SUITE 4E2 THERAPY SERVICES
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-1002
Mailing Address - Country:US
Mailing Address - Phone:314-454-2443
Mailing Address - Fax:314-454-2380
Practice Address - Street 1:1 CHILDRENS PL
Practice Address - Street 2:SUITE 4E2 THERAPY SERVICES
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1002
Practice Address - Country:US
Practice Address - Phone:314-454-2443
Practice Address - Fax:314-454-2380
Is Sole Proprietor?:No
Enumeration Date:2012-10-11
Last Update Date:2012-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO01130235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist