Provider Demographics
NPI:1568731222
Name:WESTHOFF-GRANT, LAURINDA (SLP MA,CCC)
Entity Type:Individual
Prefix:MRS
First Name:LAURINDA
Middle Name:
Last Name:WESTHOFF-GRANT
Suffix:
Gender:F
Credentials:SLP MA,CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 YARMOUTH LN
Mailing Address - Street 2:
Mailing Address - City:NESCONSET
Mailing Address - State:NY
Mailing Address - Zip Code:11767-1610
Mailing Address - Country:US
Mailing Address - Phone:631-780-6300
Mailing Address - Fax:
Practice Address - Street 1:52 3RD AVE
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:NY
Practice Address - Zip Code:11717-4651
Practice Address - Country:US
Practice Address - Phone:631-434-2215
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-23
Last Update Date:2011-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009179235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist