Provider Demographics
NPI:1528297637
Name:GRAFF, LEA (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:LEA
Middle Name:
Last Name:GRAFF
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 1:7860 TANIAS CT
Mailing Address - Street 2:
Mailing Address - City:APTOS
Mailing Address - State:CA
Mailing Address - Zip Code:95003-3979
Mailing Address - Country:US
Mailing Address - Phone:831-566-0317
Mailing Address - Fax:
Practice Address - Street 1:7860 TANIAS CT
Practice Address - Street 2:SUITE A
Practice Address - City:APTOS
Practice Address - State:CA
Practice Address - Zip Code:95003-3979
Practice Address - Country:US
Practice Address - Phone:831-566-0317
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-09
Last Update Date:2009-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10435235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist