Provider Demographics
NPI:1922423524
Name:GRIHALVA, ANN (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:
Last Name:GRIHALVA
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:
Other - Last Name:WILMSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC-SLP
Mailing Address - Street 1:1595 S CALUMET RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:CHESTERTON
Mailing Address - State:IN
Mailing Address - Zip Code:46304-2388
Mailing Address - Country:US
Mailing Address - Phone:844-896-0235
Mailing Address - Fax:
Practice Address - Street 1:1595 S CALUMET RD STE 3
Practice Address - Street 2:
Practice Address - City:CHESTERTON
Practice Address - State:IN
Practice Address - Zip Code:46304-2389
Practice Address - Country:US
Practice Address - Phone:844-896-0235
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-19
Last Update Date:2018-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN46002932A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist