Provider Demographics
NPI:1558559716
Name:GRIFFIN, CATHERINE LEBAHN (MCSD CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:LEBAHN
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:MCSD CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 TAYLOR DR
Mailing Address - Street 2:
Mailing Address - City:DILLON
Mailing Address - State:MT
Mailing Address - Zip Code:59725-7103
Mailing Address - Country:US
Mailing Address - Phone:406-683-5806
Mailing Address - Fax:406-683-5806
Practice Address - Street 1:209 TAYLOR DR
Practice Address - Street 2:
Practice Address - City:DILLON
Practice Address - State:MT
Practice Address - Zip Code:59725-7103
Practice Address - Country:US
Practice Address - Phone:406-683-5806
Practice Address - Fax:406-683-5806
Is Sole Proprietor?:No
Enumeration Date:2007-10-11
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT831235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT1942364450OtherNPI FOR ORGANIZATION
MT066376OtherBLUE CROSS BLUE SHIELD
MT0533630Medicaid