Provider Demographics
NPI:1922736156
Name:KATHRYN GRIFFITH LLC
Entity Type:Organization
Organization Name:KATHRYN GRIFFITH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:GRIFFITH
Authorized Official - Suffix:
Authorized Official - Credentials:MSCCC-SLP
Authorized Official - Phone:317-341-5421
Mailing Address - Street 1:8626 E 116TH ST STE 250
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46038-2853
Mailing Address - Country:US
Mailing Address - Phone:317-721-4391
Mailing Address - Fax:317-300-7135
Practice Address - Street 1:8626 E 116TH ST STE 250
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46038-2853
Practice Address - Country:US
Practice Address - Phone:317-721-4391
Practice Address - Fax:317-300-7135
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-15
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300064633Medicaid