Doctor Name: | MR. RICHARD GRIFFIN |
NPI Number: | 1013346782 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LPC |
License Number: | 0000001538 |
Business Practice Address: | 5924 Edgemon Rd Ooltewah, TN - 373636836 |
Business Phone Number: | 4239021098 |
Business Fax Number: | |
Mailing Address: | 5924 Edgemon Rd, OOLTEWAH |
State: | TN |
Postal Code: | 373636836 |
Phone Number: | 4239021098 |
Fax Number: | |
NPI Enumeration Date: | 11/04/2013 |
NPI Last Update Date: | 11/04/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 0000001538 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TN |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |