Provider Demographics
NPI:1942394523
Name:GRIGAS, LEYNN MEYNCKE (MA, CCC- SLP/L)
Entity Type:Individual
Prefix:MS
First Name:LEYNN
Middle Name:MEYNCKE
Last Name:GRIGAS
Suffix:
Gender:F
Credentials:MA, CCC- SLP/L
Other - Prefix:
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Mailing Address - Street 1:753 DALHART AVE
Mailing Address - Street 2:
Mailing Address - City:ROMEOVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60446-1156
Mailing Address - Country:US
Mailing Address - Phone:158-886-7827
Mailing Address - Fax:815-524-3194
Practice Address - Street 1:753 DALHART AVE
Practice Address - Street 2:
Practice Address - City:ROMEOVILLE
Practice Address - State:IL
Practice Address - Zip Code:60446-1156
Practice Address - Country:US
Practice Address - Phone:158-886-7827
Practice Address - Fax:815-524-3194
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2020-03-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL24200292235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist