Provider Demographics
NPI:1699972661
Name:GRAFF, RENEE ROSE (MS, SLP)
Entity type:Individual
Prefix:MRS
First Name:RENEE
Middle Name:ROSE
Last Name:GRAFF
Suffix:
Gender:F
Credentials:MS, SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1237 FALLS BLVD
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33327-1723
Mailing Address - Country:US
Mailing Address - Phone:954-389-1488
Mailing Address - Fax:
Practice Address - Street 1:12701 W SUNRISE BLVD
Practice Address - Street 2:EASTER SEALS SOUTH FLORIDA
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33323-0907
Practice Address - Country:US
Practice Address - Phone:954-792-8772
Practice Address - Fax:954-791-8275
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 9092235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist