Provider Demographics
NPI:1912366675
Name:GRIFFIN, JESSICA LEIGH (MS)
Entity Type:Individual
Prefix:MISS
First Name:JESSICA
Middle Name:LEIGH
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 MELROSE AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06830-6257
Mailing Address - Country:US
Mailing Address - Phone:203-869-8272
Mailing Address - Fax:
Practice Address - Street 1:100 MELROSE AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06830-6257
Practice Address - Country:US
Practice Address - Phone:203-869-8272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-23
Last Update Date:2016-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist