Healthcare Provider Details

I. General information

NPI: 1043598691
Provider Name (Legal Business Name): ABIGAIL GRIFFIN SCOTT M.S. CFY-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2011
Last Update Date: 07/26/2021
Certification Date: 07/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

207 W JACKSON ST
RIDGELAND MS
39157
US

IV. Provider business mailing address

207 W JACKSON ST
RIDGELAND MS
39157-2355
US

V. Phone/Fax

Practice location:
  • Phone: 601-362-0859
  • Fax:
Mailing address:
  • Phone: 601-362-0859
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberS4479
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: