Provider Demographics
NPI:1700296670
Name:YANNIE, GRACE
Entity type:Individual
Prefix:MS
First Name:GRACE
Middle Name:
Last Name:YANNIE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2350 ROUTE 63
Mailing Address - Street 2:
Mailing Address - City:WAYLAND
Mailing Address - State:NY
Mailing Address - Zip Code:14572-9404
Mailing Address - Country:US
Mailing Address - Phone:585-728-2211
Mailing Address - Fax:585-728-2217
Practice Address - Street 1:2350 ROUTE 63
Practice Address - Street 2:
Practice Address - City:WAYLAND
Practice Address - State:NY
Practice Address - Zip Code:14572-9404
Practice Address - Country:US
Practice Address - Phone:585-728-2211
Practice Address - Fax:585-728-2217
Is Sole Proprietor?:No
Enumeration Date:2014-05-01
Last Update Date:2025-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0237021235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist