Provider Demographics
NPI:1871932269
Name:GRIFFIN, HEATHER R (MA, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:R
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:319 S DARGAN ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29506-2538
Mailing Address - Country:US
Mailing Address - Phone:843-665-5977
Mailing Address - Fax:843-665-7017
Practice Address - Street 1:319 S DARGAN ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29506-2538
Practice Address - Country:US
Practice Address - Phone:843-665-5977
Practice Address - Fax:843-665-7017
Is Sole Proprietor?:No
Enumeration Date:2013-06-18
Last Update Date:2013-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5263235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist