Provider Demographics
NPI:1780018473
Name:GRAINGER, MIKAL MELANIE (CFY, SLP)
Entity Type:Individual
Prefix:MRS
First Name:MIKAL
Middle Name:MELANIE
Last Name:GRAINGER
Suffix:
Gender:F
Credentials:CFY, SLP
Other - Prefix:
Other - First Name:MIKI
Other - Middle Name:
Other - Last Name:LADD (MAIDEN)
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1130 17TH AVE SO.
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59405
Mailing Address - Country:US
Mailing Address - Phone:406-771-4500
Mailing Address - Fax:
Practice Address - Street 1:1130 17TH AVE SO
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59405
Practice Address - Country:US
Practice Address - Phone:406-771-4500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-29
Last Update Date:2013-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist