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
| License | State | Type | Specialty |
|---|---|---|---|
| SP#503 | AR | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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All providers in Mabelvale, AR · Speech-Language Pathologist in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.