Provider Demographics
NPI:1417113879
Name:GRIFFITH, MARISSA LYNN (MS CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:MARISSA
Middle Name:LYNN
Last Name:GRIFFITH
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:89 CLEAR CREEK CIR
Mailing Address - Street 2:
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-6254
Mailing Address - Country:US
Mailing Address - Phone:305-772-8034
Mailing Address - Fax:
Practice Address - Street 1:89 CLEAR CREEK CIR
Practice Address - Street 2:
Practice Address - City:GARNER
Practice Address - State:NC
Practice Address - Zip Code:27529-6254
Practice Address - Country:US
Practice Address - Phone:305-772-8034
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-05
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ 4283235Z00000X
NC8387235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist