Provider Demographics
NPI:1609600055
Name:DIPIERRO, GRETA (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:GRETA
Middle Name:
Last Name:DIPIERRO
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 PINE ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04106-2944
Mailing Address - Country:US
Mailing Address - Phone:207-400-6786
Mailing Address - Fax:
Practice Address - Street 1:267 ALFRED ST APT 2
Practice Address - Street 2:
Practice Address - City:BIDDEFORD
Practice Address - State:ME
Practice Address - Zip Code:04005-4494
Practice Address - Country:US
Practice Address - Phone:978-732-8247
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-28
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MESP4185235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty