Provider Demographics
NPI:1700984564
Name:MCGRIFF, MELANIE (MED CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:MCGRIFF
Suffix:
Gender:F
Credentials:MED CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4055 JOHNS CREEK PKWY STE A
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-1299
Mailing Address - Country:US
Mailing Address - Phone:770-888-5221
Mailing Address - Fax:770-623-5544
Practice Address - Street 1:4055 JOHNS CREEK PKWY STE A
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-1299
Practice Address - Country:US
Practice Address - Phone:770-888-5221
Practice Address - Fax:770-623-5544
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2020-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP004267235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA954558226BMedicaid