Healthcare Provider Details

I. General information

NPI: 1689417230
Provider Name (Legal Business Name): KIRA GRIGGS CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2024
Last Update Date: 06/13/2024
Certification Date: 06/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

403 N GRAND ST STE A
SCHOOLCRAFT MI
49087-8466
US

IV. Provider business mailing address

777 GOGUAC ST W STE B2
SPRINGFIELD MI
49015-2097
US

V. Phone/Fax

Practice location:
  • Phone: 269-223-7786
  • Fax:
Mailing address:
  • Phone: 269-832-8224
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: