Provider Demographics
NPI:1083848873
Name:GRIFFETH, DONNA (MS ED, SLP)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:GRIFFETH
Suffix:
Gender:F
Credentials:MS ED, SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1109
Mailing Address - Street 2:
Mailing Address - City:WINDER
Mailing Address - State:GA
Mailing Address - Zip Code:30680-1109
Mailing Address - Country:US
Mailing Address - Phone:770-868-5810
Mailing Address - Fax:
Practice Address - Street 1:80 CHURCH ST
Practice Address - Street 2:
Practice Address - City:WINDER
Practice Address - State:GA
Practice Address - Zip Code:30680-1714
Practice Address - Country:US
Practice Address - Phone:770-868-5810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-07
Last Update Date:2009-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP006593235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist