Provider Demographics
NPI:1558638718
Name:GRABOWSKI, KIERSTEN LEE (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:KIERSTEN
Middle Name:LEE
Last Name:GRABOWSKI
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 1:65 CHAUCER CIR
Mailing Address - Street 2:
Mailing Address - City:BALDWINSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13027-8254
Mailing Address - Country:US
Mailing Address - Phone:315-468-2003
Mailing Address - Fax:
Practice Address - Street 1:8282 WILLETT PKWY
Practice Address - Street 2:
Practice Address - City:BALDWINSVILLE
Practice Address - State:NY
Practice Address - Zip Code:13027-1306
Practice Address - Country:US
Practice Address - Phone:315-857-0800
Practice Address - Fax:315-857-0803
Is Sole Proprietor?:No
Enumeration Date:2011-11-16
Last Update Date:2015-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021536235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist