Kyle Mark Griffin, MS, CCC - SLP

Individual provider Active NPI Speech-Language Pathologist · Mabelvale, AR

NPI 1043412919 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1043412919
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
SP#503 (AR)
Practice address
8511 Russwood LN W
Mabelvale, AR 72103-4286
Phone
(501) 888-3387
NPI assigned
Jun 4, 2007
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
SP#503ARMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SP#503 AR Yes

Addresses

Primary practice location

8511 Russwood LN W
Mabelvale, AR 72103-4286

Mailing address

8511 Russwood LN W
Mabelvale, AR 72103-4286
Phone (501) 888-3387

Other providers in Mabelvale, AR

All providers in Mabelvale, AR · Speech-Language Pathologist in Arkansas

Sources for this page

Verify at the official NPI Registry.