Provider Demographics
NPI:1790081404
Name:BROWN, GRIFFIN PORTER (SLPA)
Entity Type:Individual
Prefix:MR
First Name:GRIFFIN
Middle Name:PORTER
Last Name:BROWN
Suffix:
Gender:M
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 N CLASSEN BLVD
Mailing Address - Street 2:SUITE 601
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73106-5800
Mailing Address - Country:US
Mailing Address - Phone:405-355-3015
Mailing Address - Fax:
Practice Address - Street 1:1211 N SHARTEL AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73103-2400
Practice Address - Country:US
Practice Address - Phone:405-355-3239
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-28
Last Update Date:2011-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKSLPA72355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant