Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | SW137493 | PA |
NPI | 1003414699 |
---|---|
Provider Name | Dan Hayes Griffiths III |
First Address | Kingston, PA 18704-3603 |
Second Address | Dunmore, PA 18512-1943 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/10/2020 |
Last Update Date | 20/10/2020 |