Healthcare Provider Details

I. General information

NPI: 1619957800
Provider Name (Legal Business Name): BETH-ANN GRIESSER MCSWEENEY M.ED, CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BETH-ANN GRIESSER RAU M.ED, CCC-SLP

II. Dates (important events)

Enumeration Date: 01/23/2006
Last Update Date: 04/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6425 RICHMOND RD
WILLIAMSBURG VA
23188-7202
US

IV. Provider business mailing address

2529 KINGS CREEK RD
HAYES VA
23072-4325
US

V. Phone/Fax

Practice location:
  • Phone: 757-585-7176
  • Fax:
Mailing address:
  • Phone: 678-595-5558
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSA 7657
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number2202006889
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: