Individual
CARISSA GREVENGOED
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
96 FOREST ST, PEABODY, MA 01960-3907
(772) 480-7068
Mailing address
3730 7TH TER STE 202, VERO BEACH, FL 32960-7325
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
78648-SP-SL
MA
235Z00000X
Speech-Language Pathologist
9936
FL
235Z00000X
Speech-Language Pathologist
—
MA
Other
Enumeration date
02/01/2021
Last updated
09/06/2022
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