Provider Demographics
NPI:1194994855
Name:GRIFFITH, KIMELA LEANN (MS CCC SLP)
Entity type:Individual
Prefix:MS
First Name:KIMELA
Middle Name:LEANN
Last Name:GRIFFITH
Suffix:
Gender:F
Credentials:MS CCC SLP
Other - Prefix:MISS
Other - First Name:KIMELA
Other - Middle Name:LEANN
Other - Last Name:SMOTHERMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS CCC SLP
Mailing Address - Street 1:PO BOX 936
Mailing Address - Street 2:
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38503
Mailing Address - Country:US
Mailing Address - Phone:931-510-5326
Mailing Address - Fax:
Practice Address - Street 1:815 WALNUT AVE
Practice Address - Street 2:NHC HEALTHCARE CENTER
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501
Practice Address - Country:US
Practice Address - Phone:931-528-5516
Practice Address - Fax:931-528-8151
Is Sole Proprietor?:No
Enumeration Date:2008-02-27
Last Update Date:2008-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1171235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist