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NPI Code Detail

MEDICARE: ELYSABETH ANNAH GRIFFIN CCC-SLP

MEDICARE: ELYSABETH ANNAH GRIFFIN CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language PathologistSLP011323GA

General Provider Information

NPI Number : 1043959893
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELYSABETH ANNAH GRIFFIN CCC-SLP
Provider Business Mailing Address
First Line : 15 HEATHER LN
Second Line :
City : VILLA RICA
State : GA
Zip : 30180-4414
Country : US
Telephone Number : 770-312-3979
Fax Number :
Provider Business Practice Location Address
First Line : 225 S PHILPOT ST
Second Line :
City : CEDARTOWN
State : GA
Zip : 30125-3021
Country : US
Telephone Number : 770-748-4116
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/31/2022
Last Update Date : 05/31/2022

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Directions to “ ELYSABETH ANNAH GRIFFIN CCC-SLP” Practice Location

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