Provider Demographics
NPI:1942454566
Name:GRISMER, MARGARET (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:GRISMER
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 MONROE ST
Mailing Address - Street 2:
Mailing Address - City:LYNBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11563-2716
Mailing Address - Country:US
Mailing Address - Phone:516-812-8576
Mailing Address - Fax:
Practice Address - Street 1:25 MONROE ST
Practice Address - Street 2:
Practice Address - City:LYNBROOK
Practice Address - State:NY
Practice Address - Zip Code:11563-2716
Practice Address - Country:US
Practice Address - Phone:516-812-8576
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-10
Last Update Date:2008-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013409235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist