Basic Information
| Provider Information | |||||||||
| NPI: | 1083124283 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GRANDIERI | ||||||||
| FirstName: | BERNADETTE | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | CCC-SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 921 COUNTRY LN | ||||||||
| Address2: | |||||||||
| City: | INDIANA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 157019744 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7244712942 | ||||||||
| FaxNumber: | 7218018147 | ||||||||
| Practice Location | |||||||||
| Address1: | 501 PLUSH MILL RD | ||||||||
| Address2: | |||||||||
| City: | WALLINGFORD | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190866040 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7244712942 | ||||||||
| FaxNumber: | 7248018147 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/03/2017 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | SL013601 | PA | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.