Provider Demographics
NPI:1558493957
Name:GRAUMANN, PAUL JOEL (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:JOEL
Last Name:GRAUMANN
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 1:1908 W. 42ND ST.
Mailing Address - Street 2:SUITE B
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105
Mailing Address - Country:US
Mailing Address - Phone:605-351-7976
Mailing Address - Fax:
Practice Address - Street 1:1908 W. 42ND ST.
Practice Address - Street 2:SUITE B
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105
Practice Address - Country:US
Practice Address - Phone:605-351-7976
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD5832530Medicaid