Provider Demographics
NPI:1700061090
Name:GRIGORIAN, LIANA (SLPA)
Entity Type:Individual
Prefix:
First Name:LIANA
Middle Name:
Last Name:GRIGORIAN
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10213 ORANGE GROVE AVE
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90601-2142
Mailing Address - Country:US
Mailing Address - Phone:562-743-3422
Mailing Address - Fax:
Practice Address - Street 1:2730 DEL MAR AVE
Practice Address - Street 2:
Practice Address - City:ROSEMEAD
Practice Address - State:CA
Practice Address - Zip Code:91770-3026
Practice Address - Country:US
Practice Address - Phone:626-307-3425
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-04
Last Update Date:2008-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5552355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant