NPI 1104018514

Stacey Lyn van Grinsven, MSCFYSLP

Practitioner Speech-Language Pathologist De Pere, WI

Practice location

Address: 1601 Lawrence Dr STE 100, De Pere, WI 54115-3931
Phone: (920) 496-4700
Mailing address: PO Box 19070, Green Bay, WI 54307-9070

Registered specialties

Speech-Language Pathologist Primary

Speech, Language and Hearing Service Providers Taxonomy 235Z00000X Licence 2953-154 (WI)

Other Speech-Language Pathologist providers in Wisconsin →

Registry record

NPI: 1104018514
Entity type: Individual
Sex (as registered): Female
NPI issued: 10 Aug 2007
Record last updated: 18 Jan 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.