Provider Demographics
NPI:1336425479
Name:GRABOIS, DAWN LORI (MS,CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:LORI
Last Name:GRABOIS
Suffix:
Gender:F
Credentials:MS,CCC-SLP
Other - Prefix:MRS
Other - First Name:DAWN
Other - Middle Name:LORI
Other - Last Name:GRABOIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS,CCC-SLP
Mailing Address - Street 1:113 ROXTON RD
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-1143
Mailing Address - Country:US
Mailing Address - Phone:516-931-1038
Mailing Address - Fax:
Practice Address - Street 1:113 ROXTON RD
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-1143
Practice Address - Country:US
Practice Address - Phone:516-931-1038
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-02
Last Update Date:2011-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0007635235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0007635Medicaid
NY235Z00000XMedicaid