Provider Demographics
NPI:1538705546
Name:GRONER, STEPHEN (MS, CCC-SLP)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:
Last Name:GRONER
Suffix:
Gender:M
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 1:6 NATHAN DR
Mailing Address - Street 2:
Mailing Address - City:STEVENS
Mailing Address - State:PA
Mailing Address - Zip Code:17578-8001
Mailing Address - Country:US
Mailing Address - Phone:717-875-6770
Mailing Address - Fax:
Practice Address - Street 1:6 NATHAN DR
Practice Address - Street 2:
Practice Address - City:STEVENS
Practice Address - State:PA
Practice Address - Zip Code:17578-8001
Practice Address - Country:US
Practice Address - Phone:717-875-6770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-25
Last Update Date:2019-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL013816235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist