Organization
SPEECH PATHOLOGY ENRICHMENT LANGUAGE & LITERACY CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTENE G GRAVLEY M.S., CCC-SLP (OWNER)
(907) 336-7323
Entity
Organization
Contact information
Practice address
4050 LAKE OTIS PKWY, SUITE 204-C, ANCHORAGE, AK 99508-5223
(907) 336-7323
(907) 277-7355
Mailing address
4050 LAKE OTIS PKWY, SUITE 204-C, ANCHORAGE, AK 99508-5223
(907) 336-7323
(907) 277-7355
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
239
AK
235Z00000X
Speech-Language Pathologist
Primary
285
AK
235Z00000X
Speech-Language Pathologist
90
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SP0003
—
AK
05
—
SP5061
—
AK
05
—
SP6595
—
AK
Enumeration date
09/08/2009
Last updated
09/08/2009
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