Provider Demographics
NPI:1871364026
Name:GRONSKY, PAYTON GRAY
Entity type:Individual
Prefix:
First Name:PAYTON
Middle Name:GRAY
Last Name:GRONSKY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2325 E RIO SALADO PKWY
Mailing Address - Street 2:APT #3043
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85288
Mailing Address - Country:US
Mailing Address - Phone:602-689-5089
Mailing Address - Fax:
Practice Address - Street 1:1 W ELLIOT RD #109
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85284
Practice Address - Country:US
Practice Address - Phone:480-374-4341
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-15
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ149992355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant