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General NPI Number Information
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NPI Number | 1063831253
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Entity Type | Individual
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Provider Name | MARY ELIZABETH GRECO CCC/SLP
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Gender | Female
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Dates
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Enumeration Date | 04/15/2014
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Last Update Date | 05/12/2025
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Provider Practice Location Address
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Address Line | 1414 S MILLER ST STE 10G
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City | SANTA MARIA
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State | CA
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Zip | 93454-6916
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Country | US
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Telephone | 805-750-7800
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Fax |
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Provider Business Mailing Address
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Address Line | 305 GONZALES DR
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City | LOS ALAMOS
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State | CA
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Zip | 93440-5012
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Country | US
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Telephone | 805-895-3123
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 13372
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License Number State | CA
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