Healthcare Provider Details

I. General information

NPI: 1891609111
Provider Name (Legal Business Name): JESSICA HOPE GRIFFIN LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4948 COLLARD VALLEY RD
ARAGON GA
30104-1834
US

IV. Provider business mailing address

4948 COLLARD VALLEY RD
ARAGON GA
30104-1834
US

V. Phone/Fax

Practice location:
  • Phone: 863-370-4203
  • Fax:
Mailing address:
  • Phone: 863-370-4203
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMT015952
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: