Provider Demographics
NPI:1427464528
Name:GRIFFIN, JENNA RAY (MS, CFY-SLP)
Entity type:Individual
Prefix:
First Name:JENNA
Middle Name:RAY
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:MS, CFY-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:926 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MT
Mailing Address - Zip Code:59044-1916
Mailing Address - Country:US
Mailing Address - Phone:406-238-6400
Mailing Address - Fax:406-238-6464
Practice Address - Street 1:2900 12TH AVE N
Practice Address - Street 2:SUITE 10W
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-7506
Practice Address - Country:US
Practice Address - Phone:406-238-6400
Practice Address - Fax:406-238-6464
Is Sole Proprietor?:No
Enumeration Date:2014-07-09
Last Update Date:2014-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTSLP-SP-TMP-4059235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist