Provider Demographics
NPI:1922996545
Name:ACEVEDO, GRISEL ENID
Entity type:Individual
Prefix:
First Name:GRISEL
Middle Name:ENID
Last Name:ACEVEDO
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 1:429 CALLE JESUS RAMOS
Mailing Address - Street 2:
Mailing Address - City:MOCA
Mailing Address - State:PR
Mailing Address - Zip Code:00676-4574
Mailing Address - Country:US
Mailing Address - Phone:787-597-1350
Mailing Address - Fax:
Practice Address - Street 1:429 CALLE JESUS RAMOS
Practice Address - Street 2:
Practice Address - City:MOCA
Practice Address - State:PR
Practice Address - Zip Code:00676-4574
Practice Address - Country:US
Practice Address - Phone:787-597-1350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-24
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
7112355S0801X
PR7112355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language AssistantGroup - Single Specialty