Healthcare Provider Details

I. General information

NPI: 1851848519
Provider Name (Legal Business Name): AMY M GRABLE M.S, CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2016
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 CENTRAL AVE
UNION BEACH NJ
07735-2939
US

IV. Provider business mailing address

105 CENTRAL AVE
UNION BEACH NJ
07735-2939
US

V. Phone/Fax

Practice location:
  • Phone: 908-603-1460
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number41YS00509300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: