SUSAN GRISSOM (NPI# 1326479080) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326479080 |
| Entity Type | Individual |
| Full Name | SUSAN GRISSOM |
| Practice Address |
6776 Lake Drive Advance Therapy Lino Lakes MN 55014 |
| Mailing Address |
13585 Elkwood Dr Apple Valley MN 55124-5232 |
| Practice Telephone | 6514982071 |
| Mailing Telephone | 9524514575 |
| Enumeration Date | 2013-12-06 |
| Last Update Date | 2013-12-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 235Z00000X | Speech-Language Pathologist | 251272 | MN | Speech, Language and Hearing Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851804843 | Susan Elizabeth Grissom | Speech-Language Pathologist | 238 E Hazel St, West Chicago, IL 60185-3512 | 2017-11-13 |
| Street Address |
6776 LAKE DRIVE ADVANCE THERAPY |
| City | LINO LAKES |
| State | MN |
| Zip Code | 55014 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760007918 | Andrea Bistodeau | Pharmacist | 4369 Ball Road Ne, Blaine, MN 55014 | 2020-06-13 |
| 1720462617 | Lino Lakes Gw, LLC | Assisted Living Facility | 675 Market Place Drive, Lino Lakes, MN 55014 | 2015-07-10 |
| 1578973376 | Beth Ann Schumacher | Counselor | 49 Central St Ste 2, Circle Pines, MN 55014 | 2014-05-01 |
| 1154759173 | Jennifer Cunningham | Massage Therapist | 3865 97th Ln Ne, Blaine, MN 55014 | 2013-10-30 |
| 1760695316 | Carol Elaine Jillian-ohana | Chiropractor | 7094 Lake Drive, Circle of Healing Arts, Lino Lakes, MN 55014 | 2007-05-08 |
| 1750434064 | Pamela Lynn Lenz | Speech-Language Pathologist | 6776 Lake Dr., #220, Lino Lakes, MN 55014 | 2007-01-19 |
| 1447342118 | David Joseph Beyer | Counselor | 7578 Leonard Ave., Lino Lakes, MN 55014 | 2006-09-29 |
| 1710089156 | Joel David Buys | Chiropractor | 7661 Lake Dr, Lino Lakes, MN 55014 | 2006-09-05 |
| 1881655538 | John M Stentz | Dentist | 640 Civic Heights Dr, Circle Pines, MN 55014 | 2006-03-31 |
| 1417556853 | Dai Hoang | Pharmacist | 4369 Ball Road Ne, Blaine, MN 55014 | 2020-10-17 |
| Find all providers in zip 55014 | ||||
| Taxonomy Code | 235Z00000X |
| Grouping | Speech, Language and Hearing Service Providers |
| Classification | Speech-Language Pathologist |
| The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing. |
| Notes: "Scope of Practice in Speech-Language Pathology", American Speech-Language-Hearing Association, 2013. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750434064 | Pamela Lynn Lenz | Speech-Language Pathologist | 6776 Lake Dr., #220, Lino Lakes, MN 55014 | 2007-01-19 |
| 1386613412 | Jennifer Mae Jensen | Speech-Language Pathologist | 6776 Lake Dr, 220, Lino Lakes, MN 55014-1191 | 2006-03-14 |
| 1376153346 | Angie Thompson | Speech-Language Pathologist | 6776 Lake Dr Ste 220, Lino Lakes, MN 55014-1192 | 2020-08-05 |
| 1932656691 | Jessica Vietor | Speech-Language Pathologist | 6776 Lake Dr, 220, Lino Lakes, MN 55014-1191 | 2016-09-09 |
| 1841747508 | Anna Pfau | Speech-Language Pathologist | 6776 Lake Dr Ste 220, Lino Lakes, MN 55014-1192 | 2016-09-09 |
| 1801255039 | Kelsy Haltvick | Speech-Language Pathologist | 6776 Lake Dr, Suite 220, Lino Lakes, MN 55014-1191 | 2016-02-16 |
| 1851780423 | Allison Fayard | Speech-Language Pathologist | 6776 Lake Dr Ste 220, Lino Lakes, MN 55014-1192 | 2015-01-20 |
| 1891120028 | Ashley K Sellwood | Speech-Language Pathologist | 6776 Lake Dr Ste 220, Lino Lakes, MN 55014-1192 | 2013-09-06 |
| 1043644784 | Advance Therapy | Speech-Language Pathologist | 6776 Lake Dr, Lino Lakes, MN 55014-1191 | 2013-08-29 |
| 1063764900 | Shana Banas | Speech-Language Pathologist | 6776 Lake Dr, 220, Lino Lakes, MN 55014-1191 | 2012-10-02 |
| Find all providers in LINO LAKES | ||||
| City | LINO LAKES |
| Zip Code | 55014 |
Please comment or provide details below to improve the information on SUSAN GRISSOM.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.