Provider Demographics
NPI:1679909493
Name:GRUND, VANESSA MERA (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:MERA
Last Name:GRUND
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 1:569 52ND ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-2720
Mailing Address - Country:US
Mailing Address - Phone:347-237-1999
Mailing Address - Fax:
Practice Address - Street 1:569 52ND ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-2720
Practice Address - Country:US
Practice Address - Phone:347-237-1999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-25
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist