Provider Demographics
NPI:1962124008
Name:VOLGARINO, GRACE (SLP)
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:
Last Name:VOLGARINO
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:GRACE
Other - Middle Name:
Other - Last Name:VOLGARINO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1355 SHERMAN RD STE 501
Mailing Address - Street 2:
Mailing Address - City:HIAWATHA
Mailing Address - State:IA
Mailing Address - Zip Code:52233-1208
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1355 SHERMAN RD STE 501
Practice Address - Street 2:
Practice Address - City:HIAWATHA
Practice Address - State:IA
Practice Address - Zip Code:52233-1208
Practice Address - Country:US
Practice Address - Phone:319-350-5468
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-15
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA115919235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA115919Medicaid