Provider Demographics
NPI:1205094422
Name:GRIFFIN, BILLIE SUANNE (MA, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:BILLIE
Middle Name:SUANNE
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:BILLIE
Other - Middle Name:SUANNE
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, CCC-SLP
Mailing Address - Street 1:1119 OLD HUMBOLDT RD
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38305-1752
Mailing Address - Country:US
Mailing Address - Phone:731-554-5169
Mailing Address - Fax:731-668-1666
Practice Address - Street 1:1119 OLD HUMBOLDT RD
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38305-1752
Practice Address - Country:US
Practice Address - Phone:731-554-5169
Practice Address - Fax:731-668-1666
Is Sole Proprietor?:No
Enumeration Date:2008-05-23
Last Update Date:2018-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist