Provider Demographics
NPI:1568201366
Name:GRIFFIN, ARIANNA PHYLLIS
Entity type:Individual
Prefix:
First Name:ARIANNA
Middle Name:PHYLLIS
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3512 NUTMEG DR
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-2684
Mailing Address - Country:US
Mailing Address - Phone:678-908-6562
Mailing Address - Fax:
Practice Address - Street 1:3295 RIVER EXCHANGE DR STE 170
Practice Address - Street 2:
Practice Address - City:PEACHTREE CORNERS
Practice Address - State:GA
Practice Address - Zip Code:30092-4220
Practice Address - Country:US
Practice Address - Phone:404-500-8264
Practice Address - Fax:404-800-0415
Is Sole Proprietor?:No
Enumeration Date:2024-05-21
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP013031235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist