Healthcare Provider Details

I. General information

NPI: 1073445979
Provider Name (Legal Business Name): GRACIE ROSE GRINSTEINER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5000 GOODMAN ST
TIMNATH CO
80547-2379
US

IV. Provider business mailing address

154 WILLOWSTONE DR
ESTES PARK CO
80517-9173
US

V. Phone/Fax

Practice location:
  • Phone: 970-900-6930
  • Fax:
Mailing address:
  • Phone: 701-527-7855
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: