Provider Demographics
NPI:1316232531
Name:GRISWOLD, CARRIE M (SPEECH PATHOLOGIST)
Entity type:Individual
Prefix:MRS
First Name:CARRIE
Middle Name:M
Last Name:GRISWOLD
Suffix:
Gender:F
Credentials:SPEECH PATHOLOGIST
Other - Prefix:
Other - First Name:CARRIE
Other - Middle Name:
Other - Last Name:DEVANEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SPEECH PATHOLOGIST
Mailing Address - Street 1:2126 PENFIELD RD
Mailing Address - Street 2:
Mailing Address - City:PENFIELD
Mailing Address - State:NY
Mailing Address - Zip Code:14526-1736
Mailing Address - Country:US
Mailing Address - Phone:585-249-6600
Mailing Address - Fax:
Practice Address - Street 1:2126 PENFIELD RD
Practice Address - Street 2:
Practice Address - City:PENFIELD
Practice Address - State:NY
Practice Address - Zip Code:14526-1736
Practice Address - Country:US
Practice Address - Phone:585-249-6600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-15
Last Update Date:2011-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist