Provider Demographics
NPI:1215294186
Name:GRIEVE, SUSAN K
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:K
Last Name:GRIEVE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 CASEY ROAD
Mailing Address - Street 2:WILLIAMSVILLE CENTRAL SCHOOL DISTRICT
Mailing Address - City:EAST AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14051
Mailing Address - Country:US
Mailing Address - Phone:716-626-8000
Mailing Address - Fax:716-626-8089
Practice Address - Street 1:105 CASEY ROAD
Practice Address - Street 2:CASEY MIDDLE SCHOOL
Practice Address - City:EAST AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14051
Practice Address - Country:US
Practice Address - Phone:716-626-8585
Practice Address - Fax:716-626-8562
Is Sole Proprietor?:No
Enumeration Date:2012-04-17
Last Update Date:2012-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005899-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist