Provider Demographics
NPI:1720856909
Name:GRIGG, SAMANTHA ERIN
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:ERIN
Last Name:GRIGG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9805 GABLE RIDGE TER APT D
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-4668
Mailing Address - Country:US
Mailing Address - Phone:443-717-4216
Mailing Address - Fax:
Practice Address - Street 1:9805 GABLE RIDGE TER APT D
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-4668
Practice Address - Country:US
Practice Address - Phone:443-717-4216
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-18
Last Update Date:2025-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
235Z00000X
MD11033235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist