Provider Demographics
NPI:1801049051
Name:GRATTON, NANCY (SLP)
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:
Last Name:GRATTON
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 FOREST RD
Mailing Address - Street 2:
Mailing Address - City:BURNT HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:12027-9743
Mailing Address - Country:US
Mailing Address - Phone:518-399-4016
Mailing Address - Fax:518-399-4016
Practice Address - Street 1:29 FOREST RD
Practice Address - Street 2:
Practice Address - City:BURNT HILLS
Practice Address - State:NY
Practice Address - Zip Code:12027-9743
Practice Address - Country:US
Practice Address - Phone:518-399-4016
Practice Address - Fax:518-399-4016
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-01
Last Update Date:2008-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0085011235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist