Provider Demographics
NPI:1285334334
Name:LOEW, GRACE (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:
Last Name:LOEW
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 W STANFIELD RD
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:OH
Mailing Address - Zip Code:45373-2572
Mailing Address - Country:US
Mailing Address - Phone:937-339-5100
Mailing Address - Fax:
Practice Address - Street 1:3625 LITTLE YORK RD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45414-2454
Practice Address - Country:US
Practice Address - Phone:937-415-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-07
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6124235Z00000X
OHSP.13708235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist