Provider Demographics
NPI:1316085004
Name:ADRIANA DIGRANDE MS CCCSLP PLLP
Entity type:Organization
Organization Name:ADRIANA DIGRANDE MS CCCSLP PLLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FLUENCY SPECIALIST
Authorized Official - Prefix:MS
Authorized Official - First Name:ADRIANA
Authorized Official - Middle Name:J
Authorized Official - Last Name:DIGRANDE
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCCSLP BRSFD
Authorized Official - Phone:781-665-6623
Mailing Address - Street 1:PO BOX 80418
Mailing Address - Street 2:
Mailing Address - City:STONEHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02180
Mailing Address - Country:US
Mailing Address - Phone:781-665-6623
Mailing Address - Fax:781-665-6361
Practice Address - Street 1:19 MUZZEY STREET
Practice Address - Street 2:SUITE 311
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02421
Practice Address - Country:US
Practice Address - Phone:781-665-6623
Practice Address - Fax:781-665-6361
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MASP1620SL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
36242OtherHARVARD PILGRIM HEALTH CA
Q00784OtherBLUE CROSS BLUE SHIELD