MEDICARE: ABIGAIL GRIEST M.S., CF-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
1	235Z00000X	Speech-Language Pathologist	COND.2016198-SP	OH

General Provider Information

NPI Number	:	1255787289
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABIGAIL GRIEST M.S., CF-SLP

Provider Business Mailing Address
First Line	:	5263 ORMAND RD
Second Line	:
City	:	WEST CARROLLTON
State	:	OH
Zip	:	45449-2772
Country	:	US
Telephone Number	:	937-475-1876
Fax Number	:

Provider Business Practice Location Address
First Line	:	5758 HARSHMANVILLE RD
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45424-5313
Country	:	US
Telephone Number	:	937-237-6392
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/09/2016
Last Update Date	:	05/09/2016

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