Christina A Grisanzio, CF-SLP

Individual provider Active NPI Speech-Language Pathologist · New Gloucester, ME

NPI 1124615810 · NPPES record last updated Dec 29, 2020

Key facts

NPI
1124615810
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
ST3396 (ME)
Practice address
71 Pineland Dr
New Gloucester, ME 04260-5127
Phone
(207) 878-9663
NPI assigned
Dec 29, 2020
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
ST3396MEMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X ST3396 ME Yes

Addresses

Primary practice location

71 Pineland Dr
New Gloucester, ME 04260-5127

Mailing address

31 E Grand Ave Apt 72
Old Orchard Beach, ME 04064-2846
Phone (603) 203-6679

Other providers in New Gloucester, ME

All providers in New Gloucester, ME · Speech-Language Pathologist in Maine

Sources for this page

Verify at the official NPI Registry.