Granillo Speech Pathology, PLLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SP-1063 Issued in NV

Legal business name

GRANILLO SPEECH PATHOLOGY, PLLC

Practice address

3041 W Horizon Ridge Pkwy
Suite 150
Henderson, NV 89052-3948

Phone

(702) 235-3354

Fax

(702) 920-8062

NPI assigned

Mar 7, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kelli Lynn Granillo, M.S. CCC/SLPNPI 1982874798

Title

Manager/Member

Phone

(702) 235-3354

Specialties & licenses 1

Addresses

Other names 1

• Speech Patherapy Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kelli Lynn Granillo, M.S. CCC/SLP

  • Speech-Language Pathologist
  • Henderson, NV
  • NPI 1982874798
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1204848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204848000000",
    "number": "1023288982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7461 COYOTE CAVE AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891133294",
            "telephone_number": "702-235-3354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3041 W HORIZON RIDGE PKWY",
            "address_2": "SUITE 150",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890523948",
            "telephone_number": "702-235-3354",
            "fax_number": "702-920-8062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANILLO SPEECH PATHOLOGY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-07",
        "last_updated": "2008-03-07",
        "status": "A",
        "authorized_official_last_name": "GRANILLO",
        "authorized_official_first_name": "KELLI",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "MANAGER/MEMBER",
        "authorized_official_telephone_number": "702-235-3354",
        "authorized_official_credential": "M.S. CCC/SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "NV",
            "license": "SP-1063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Speech Patherapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kim Gradisher
• Matthew Aaron Graham
• Yennifer Granados
• Dennis Grandez Zavala
• Jordan M Grange
• Kelli Lynn Granillo, M.S. CCC/SLP
• Andrew Grant
• Antwanette Grant, QBA
• Brenton John Grant, MPT BHSC
• Christina Epiphany Grant, RBT

• Speech-Language Pathologist in Henderson, NV
• Providers in Henderson, NV by specialty
• Speech-Language Pathologist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.