Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 32001204A | IN |
NPI | 1023182805 |
---|---|
Provider Name | Cynthia Lynn Griffith |
First Address | Portage, IN 46368-4187 |
Second Address | Chesterton, IN 46304-3285 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/11/2006 |
Last Update Date | 08/07/2007 |