MEDICARE: ERIN ANN GRAMLICH 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
1	235Z00000X	Speech-Language Pathologist	2202006461	VA

General Provider Information

NPI Number	:	1841572781
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIN ANN GRAMLICH CCC-SLP

Provider Business Mailing Address
First Line	:	906 TRAILVIEW BLVD SE
Second Line	:	SUITE A
City	:	LEESBURG
State	:	VA
Zip	:	20175-4415
Country	:	US
Telephone Number	:	703-777-0561
Fax Number	:	703-737-8235

Provider Business Practice Location Address
First Line	:	906 TRAILVIEW BLVD SE
Second Line	:	SUITE A
City	:	LEESBURG
State	:	VA
Zip	:	20175-4415
Country	:	US
Telephone Number	:	703-777-0561
Fax Number	:	703-737-8235

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/16/2011
Last Update Date	:	06/18/2015

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Directions to “ ERIN ANN GRAMLICH CCC-SLP” Practice Location

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