Provider Demographics
NPI:1851077069
Name:GRASKEWICZ, BAILEY (MS CF-SLP)
Entity Type:Individual
Prefix:
First Name:BAILEY
Middle Name:
Last Name:GRASKEWICZ
Suffix:
Gender:F
Credentials:MS CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:406 S WARREN ST
Mailing Address - Street 2:
Mailing Address - City:WARRENSBURG
Mailing Address - State:MO
Mailing Address - Zip Code:64093-2149
Mailing Address - Country:US
Mailing Address - Phone:660-676-2141
Mailing Address - Fax:
Practice Address - Street 1:1800 W IRISH LN
Practice Address - Street 2:
Practice Address - City:KNOB NOSTER
Practice Address - State:MO
Practice Address - Zip Code:65336-1020
Practice Address - Country:US
Practice Address - Phone:660-687-0187
Practice Address - Fax:660-687-0221
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-22
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2023024426235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist