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General NPI Number Information
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NPI Number | 1457151995
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Entity Type | Organization
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Legal Business Name | GRASE SPEAK LIFE SPEECH THERAPY & ASSOCIATES LLC
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Dates
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Enumeration Date | 03/14/2025
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Last Update Date | 03/14/2025
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Provider Practice Location Address
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Address Line | 5833 POPLAR HALL DR
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City | NORFOLK
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State | VA
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Zip | 23502-3815
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Country | US
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Telephone | 757-775-7479
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Fax |
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Provider Business Mailing Address
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Address Line | 2 PATRIOT CRES
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City | HAMPTON
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State | VA
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Zip | 23666-2815
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | TYRONECIA GRASE
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Credential |
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Telephone | 901-220-4094
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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