Provider Demographics
NPI:1871104406
Name:GRIGGS, WENDY (SLP)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:
Last Name:GRIGGS
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1740 RIVEROAK RD
Mailing Address - Street 2:
Mailing Address - City:INMAN
Mailing Address - State:SC
Mailing Address - Zip Code:29349-8170
Mailing Address - Country:US
Mailing Address - Phone:570-772-0122
Mailing Address - Fax:
Practice Address - Street 1:2400 WINCHESTER PL STE 102A
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29301-1518
Practice Address - Country:US
Practice Address - Phone:864-579-7188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-17
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7087235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist