Phaedra Phanae Griffin, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

891251300 Issued in FL

Practice address

448 W Donegan Ave
Kissimmee, FL 34741-2335

Phone

(407) 932-3445

NPI assigned

Aug 5, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295913600000",
    "number": "1477562122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13434 SOUTHMEADOW DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328246164",
            "telephone_number": "407-222-2814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "448 W DONEGAN AVE",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347412335",
            "telephone_number": "407-932-3445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIFFIN",
        "first_name": "PHAEDRA",
        "middle_name": "PHANAE",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-05",
        "last_updated": "2011-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "891251300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891251300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stella Gress Mazzillo
• Grier Home Care Services LLC
• Grier LLC
• Garrett Kinard Griffin, PSY.D.
• Jason P Griffin, DO
• Sandra Fay Griffiths
• Adam L Griggs, D.O.
• Courtney D Griggs, BCBA
• Markeisha Griner
• Kaley Ann Griswold, RN

• Speech-Language Pathologist in Kissimmee, FL
• Providers in Kissimmee, FL by specialty
• Speech-Language Pathologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.