Provider Demographics
NPI:1295983633
Name:GRUNWALD, ELEANOR ELIZABETH (MA,FAAA,CCC-A)
Entity type:Individual
Prefix:
First Name:ELEANOR
Middle Name:ELIZABETH
Last Name:GRUNWALD
Suffix:
Gender:F
Credentials:MA,FAAA,CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 PROFESSIONAL BLVD
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47714-8009
Mailing Address - Country:US
Mailing Address - Phone:812-473-2060
Mailing Address - Fax:812-476-5118
Practice Address - Street 1:1020 PROFESSIONAL BLVD
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47714-8009
Practice Address - Country:US
Practice Address - Phone:812-473-2060
Practice Address - Fax:812-476-5118
Is Sole Proprietor?:No
Enumeration Date:2008-08-27
Last Update Date:2008-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN23002411A231H00000X, 237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter