Provider Demographics
NPI:1972953818
Name:GRIFFIN THERAPY SERVICES
Entity Type:Organization
Organization Name:GRIFFIN THERAPY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOEECH PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:CANDICE
Authorized Official - Middle Name:BURGESS
Authorized Official - Last Name:GRIFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:MSCCC/SLP
Authorized Official - Phone:270-559-5888
Mailing Address - Street 1:269 COUNTRY CLUB LN
Mailing Address - Street 2:
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42001-4703
Mailing Address - Country:US
Mailing Address - Phone:270-559-5888
Mailing Address - Fax:270-441-5271
Practice Address - Street 1:269 COUNTRY CLUB LN
Practice Address - Street 2:
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42001-4703
Practice Address - Country:US
Practice Address - Phone:270-559-5888
Practice Address - Fax:270-441-5271
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-21
Last Update Date:2016-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0689235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty