Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0700X | Adult Development & Aging Psychologist | 4813 | OH |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 4813 | OH |
Y | 103G00000X | Clinical Psychologist | 4813 | OH |
Y | 103TC0700X | Clinical Psychologist | 4813 | OH |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 4813 | OH |
N | 103TF0000X | Family Psychologist | 4813 | OH |
N | 103TH0004X | Health Psychologist | 4813 | OH |
N | 103TM1800X | Intellectual & Developmental Disabilities | 4813 | OH |
NPI | 1063684892 |
---|---|
Provider Name | Dr. Michael D. Griffith |
First Address | Lima, OH 45805-1232 |
Second Address | Lima, OH 45805-1232 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2008 |
Last Update Date | 30/04/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0989864 | (05) | OH |