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General NPI Number Information
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NPI Number | 1437668514
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Entity Type | Individual
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Provider Name | KATIE GRIFFIN MATTHEWS SLP
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Gender | Female
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Dates
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Enumeration Date | 09/21/2017
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Last Update Date | 01/12/2024
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Provider Practice Location Address
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Address Line | 405 LOVE AVE
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City | TIFTON
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State | GA
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Zip | 31794-4403
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Country | US
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Telephone | 229-402-7188
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Fax |
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Provider Business Mailing Address
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Address Line | 4401 E COLONIAL DR
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City | ORLANDO
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State | FL
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Zip | 32803-5200
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Country | US
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Telephone | 513-283-4754
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SA16913
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SLP12379
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SP3823
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License Number State | ME
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