Provider Demographics
NPI:1144829730
Name:GRAULAU, KARLA MICHELLE (MS)
Entity type:Individual
Prefix:
First Name:KARLA
Middle Name:MICHELLE
Last Name:GRAULAU
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1717 AVE. PONCE DE LEON
Mailing Address - Street 2:COND. PLAZA INMACULADA I APT 2203
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00909
Mailing Address - Country:US
Mailing Address - Phone:787-452-4827
Mailing Address - Fax:
Practice Address - Street 1:359 DE DIEGO AVE STE 201
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00909-1739
Practice Address - Country:US
Practice Address - Phone:787-723-6868
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-23
Last Update Date:2021-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR0044501235Z00000X
PR004266235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty