Provider Demographics
NPI:1255787289
Name:GRIEST, ABIGAIL (MS, CF-SLP)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:GRIEST
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5263 ORMAND RD
Mailing Address - Street 2:
Mailing Address - City:WEST CARROLLTON
Mailing Address - State:OH
Mailing Address - Zip Code:45449-2772
Mailing Address - Country:US
Mailing Address - Phone:937-475-1876
Mailing Address - Fax:
Practice Address - Street 1:5758 HARSHMANVILLE RD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45424-5313
Practice Address - Country:US
Practice Address - Phone:937-237-6392
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-09
Last Update Date:2016-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOND.2016198-SP235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist