MEDICARE: LIANA GRIGORIAN SLPA

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
1	2355S0801X	Speech-Language Assistant	555	CA

General Provider Information

NPI Number	:	1700061090
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LIANA GRIGORIAN SLPA

Provider Business Mailing Address
First Line	:	10213 ORANGE GROVE AVE
Second Line	:
City	:	WHITTIER
State	:	CA
Zip	:	90601-2142
Country	:	US
Telephone Number	:	562-743-3422
Fax Number	:

Provider Business Practice Location Address
First Line	:	2730 DEL MAR AVE
Second Line	:
City	:	ROSEMEAD
State	:	CA
Zip	:	91770-3026
Country	:	US
Telephone Number	:	626-307-3425
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/04/2008
Last Update Date	:	01/04/2008

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Directions to “ LIANA GRIGORIAN SLPA” Practice Location

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