Provider Demographics
NPI:1700213303
Name:GRIFFIN, NICOLE JEANINE (MS, CCC-A)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:JEANINE
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:MS, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1115 OVERHILL DR
Mailing Address - Street 2:
Mailing Address - City:DOWNINGTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19335-4015
Mailing Address - Country:US
Mailing Address - Phone:856-689-4335
Mailing Address - Fax:
Practice Address - Street 1:30 S VALLEY RD STE 206
Practice Address - Street 2:
Practice Address - City:PAOLI
Practice Address - State:PA
Practice Address - Zip Code:19301-1473
Practice Address - Country:US
Practice Address - Phone:610-296-5857
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-27
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT006450231H00000X
VA2201000693237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist