1306716071 NPI number — ANNALEA GRANEY M.S. CCC-SLP

NPI Number: 1306716071
Health Care Provider/Practitioner: ANNALEA GRANEY M.S. CCC-SLP

NPI Number : 1306716071 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1306716071",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "GRANEY",
    "FirstName": "ANNALEA",
    "MiddleName": null,
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "M.S. CCC-SLP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "PEDIGO",
    "OtherFirstName": "ANNALEA",
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "MS CCC-SLP",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "1727 KELLER PKWY STE 19",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "KELLER",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "76248-3705",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "817-500-5895",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1727 KELLER PKWY STE 19",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "KELLER",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "76248-3705",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "817-500-5895",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "11/07/2025",
    "LastUpdateDate": "11/07/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "235Z00000X",
        "TaxonomyName": "Speech-Language Pathologist",
        "LicenseNumber": "122324",
        "LicenseNumberStateCode": "TX",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}