Provider Demographics
NPI:1578022083
Name:GRIFFIN, DANEA SPILLMAN (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:DANEA
Middle Name:SPILLMAN
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7106 MAGNOLIA BEACH RD
Mailing Address - Street 2:
Mailing Address - City:DENHAM SPRINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70706-1201
Mailing Address - Country:US
Mailing Address - Phone:225-337-0523
Mailing Address - Fax:
Practice Address - Street 1:311 VETERANS BLVD
Practice Address - Street 2:
Practice Address - City:DENHAM SPRINGS
Practice Address - State:LA
Practice Address - Zip Code:70726-4726
Practice Address - Country:US
Practice Address - Phone:225-380-1894
Practice Address - Fax:225-380-1896
Is Sole Proprietor?:No
Enumeration Date:2019-03-14
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA8091235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist