Provider Demographics
NPI:1932284304
Name:GRIFFITH, ALISHA (MS CCC A/SLP)
Entity Type:Individual
Prefix:
First Name:ALISHA
Middle Name:
Last Name:GRIFFITH
Suffix:
Gender:F
Credentials:MS CCC A/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3220 AVENUE H
Mailing Address - Street 2:APT 2N
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11210-3258
Mailing Address - Country:US
Mailing Address - Phone:718-859-3977
Mailing Address - Fax:
Practice Address - Street 1:3220 AVENUE H
Practice Address - Street 2:APT 2N
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11210-3258
Practice Address - Country:US
Practice Address - Phone:718-859-3977
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001944231H00000X
NY015460235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Not Answered235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist