Provider Demographics
NPI:1760793996
Name:GRAZIANO, JAIMEE ANN (MS)
Entity Type:Individual
Prefix:
First Name:JAIMEE
Middle Name:ANN
Last Name:GRAZIANO
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:JAIMEE
Other - Middle Name:ANN
Other - Last Name:FALLON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:23 OAKCREST AVE
Mailing Address - Street 2:
Mailing Address - City:FARMINGVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11738-1921
Mailing Address - Country:US
Mailing Address - Phone:631-320-0305
Mailing Address - Fax:
Practice Address - Street 1:23 OAKCREST AVE
Practice Address - Street 2:
Practice Address - City:FARMINGVILLE
Practice Address - State:NY
Practice Address - Zip Code:11738-1921
Practice Address - Country:US
Practice Address - Phone:631-320-0305
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-22
Last Update Date:2010-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist