Provider Demographics
NPI:1538707021
Name:HILDENSPERGER, GRACE (CF-SLP)
Entity Type:Individual
Prefix:
First Name:GRACE
Middle Name:
Last Name:HILDENSPERGER
Suffix:
Gender:F
Credentials:CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14333 SWANEE BEACH DR
Mailing Address - Street 2:
Mailing Address - City:FENTON
Mailing Address - State:MI
Mailing Address - Zip Code:48430-1463
Mailing Address - Country:US
Mailing Address - Phone:810-919-7733
Mailing Address - Fax:
Practice Address - Street 1:14333 SWANEE BEACH DR
Practice Address - Street 2:
Practice Address - City:FENTON
Practice Address - State:MI
Practice Address - Zip Code:48430-1463
Practice Address - Country:US
Practice Address - Phone:810-919-7733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-15
Last Update Date:2019-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist