Provider Demographics
NPI:1639123797
Name:GRIFFIN, BEVERLY JO (AUD)
Entity Type:Individual
Prefix:DR
First Name:BEVERLY
Middle Name:JO
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2722 WESTRIDGE CT
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80526-6503
Mailing Address - Country:US
Mailing Address - Phone:970-223-7798
Mailing Address - Fax:
Practice Address - Street 1:1100 POUDRE RIVER DR
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-3500
Practice Address - Country:US
Practice Address - Phone:970-224-1550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO43231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist