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Organization
FUNCTIONAL ORAL MOTOR AND FEEDING CONCEPTS LLC
Active
Organization
FUNCTIONAL ORAL MOTOR AND FEEDING CONCEPTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KIMBERLY A GRIFFITH SLP (OWNER/PROVIDER)
(260) 438-3586
Entity
Organization
Contact information
Practice address
6205 CONSTITUTION DR, FORT WAYNE, IN 46804-1517
(260) 438-3586
(260) 432-7046
Mailing address
6025 CONSTITUTION DR, FORT WAYNE, IN 46804
(260) 438-3586
(260) 432-7046
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200681320A
—
IN
Enumeration date
06/29/2012
Last updated
10/12/2015
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