Basic Information
| Provider Information | |||||||||
| NPI: | 1649455833 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GRATTAN | ||||||||
| FirstName: | DANA | ||||||||
| MiddleName: | MARIE | ||||||||
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| Credential: | A.U.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2520 ABERDEEN BLVD | ||||||||
| Address2: | |||||||||
| City: | GASTONIA | ||||||||
| State: | NC | ||||||||
| PostalCode: | 280540635 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7048688400 | ||||||||
| FaxNumber: | 7048688493 | ||||||||
| Practice Location | |||||||||
| Address1: | 95 CRYSTAL RUN RD | ||||||||
| Address2: | |||||||||
| City: | MIDDLETOWN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 109417001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8457036999 | ||||||||
| FaxNumber: | 8457036297 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/07/2008 | ||||||||
| LastUpdateDate: | 03/24/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 231H00000X | 12144 | NC | Y | Speech, Language and Hearing Service Providers | Audiologist |
No ID Information.