Provider Demographics
NPI:1497324487
Name:GRANITZ, CAMILLE DENISE (MS CCC SLP)
Entity Type:Individual
Prefix:MRS
First Name:CAMILLE
Middle Name:DENISE
Last Name:GRANITZ
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 1:717 COUNTY ROAD 448
Mailing Address - Street 2:
Mailing Address - City:WALLA WALLA
Mailing Address - State:WA
Mailing Address - Zip Code:99362-7162
Mailing Address - Country:US
Mailing Address - Phone:208-420-2666
Mailing Address - Fax:
Practice Address - Street 1:717 COUNTY ROAD 448
Practice Address - Street 2:
Practice Address - City:WALLA WALLA
Practice Address - State:WA
Practice Address - Zip Code:99362-7162
Practice Address - Country:US
Practice Address - Phone:208-420-2666
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-23
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist