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NPI Code Detail

MEDICARE: KYNDALL GRAYSON SLP

MEDICARE: KYNDALL GRAYSON SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist11999NC

General Provider Information

NPI Number : 1619804275
Entity Type Code : Individual
Provider Name (Legal Business Name) : KYNDALL GRAYSON SLP
Provider Business Mailing Address
First Line : 2609 BRIAR TRAIL CT
Second Line :
City : MATTHEWS
State : NC
Zip : 28104-4243
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4421 STUART ANDREW BLVD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28217-1589
Country : US
Telephone Number : 678-492-0809
Fax Number : 980-343-6960
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/07/2026
Last Update Date : 05/07/2026

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Directions to “ KYNDALL GRAYSON SLP” Practice Location

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