| Doctor Name: | GWEN GRIFFIN |
| NPI Number: | 1093895328 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LISAC |
| License Number: | 10319 |
| Business Practice Address: | 8 E Cottonwood St Cottonwood, AZ - 863264382 |
| Business Phone Number: | 9286342236 |
| Business Fax Number: | 9286348960 |
| Mailing Address: | 65 Verde Valley School Rd Apt D7, SEDONA |
| State: | AZ |
| Postal Code: | 863519017 |
| Phone Number: | 9286342236 |
| Fax Number: | 9286348960 |
| NPI Enumeration Date: | 10/17/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 10319 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |