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NPI Code Detail

MEDICARE: MRS. ELIZABETH JANE GRINSELL M.S. CCC-SLP

MEDICARE:  MRS. ELIZABETH JANE GRINSELL  M.S. CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist2202004321VA

General Provider Information

NPI Number : 1821183930
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ELIZABETH JANE GRINSELL M.S. CCC-SLP
Provider Business Mailing Address
First Line : 15000 HICKORY GROVE PL
Second Line :
City : MIDLOTHIAN
State : VA
Zip : 23112-2267
Country : US
Telephone Number : 804-321-7474
Fax Number : 804-545-3830
Provider Business Practice Location Address
First Line : 2924 BROOK RD
Second Line :
City : RICHMOND
State : VA
Zip : 23220-1215
Country : US
Telephone Number : 804-321-7474
Fax Number : 804-545-3830
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/04/2006
Last Update Date : 07/08/2007

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Directions to “ MRS. ELIZABETH JANE GRINSELL M.S. CCC-SLP” Practice Location

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