Healthcare Provider Details

I. General information

NPI: 1902782386
Provider Name (Legal Business Name): IYONA LEANNE GRIFFIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2025
Last Update Date: 08/12/2025
Certification Date: 08/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11250 FORD AVE
RICHMOND HILL GA
31324-8847
US

IV. Provider business mailing address

170 SHADY GROVE LN
SAVANNAH GA
31419-8709
US

V. Phone/Fax

Practice location:
  • Phone: 762-208-5066
  • Fax:
Mailing address:
  • Phone: 912-755-7742
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: