Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TB0200X | Cognitive & Behavioral Psychologist | 3663 | AZ |
N | 103TH0100X | Health Service | 3663 | AZ |
N | 103TR0400X | Rehabilitation Psychologist | 3663 | AZ |
NPI | 1700902764 |
---|---|
Provider Name | Susanne Griffin |
First Address | Phoenix, AZ 85020-5251 |
Second Address | Phoenix, AZ 85020-5251 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/03/2007 |
Last Update Date | 14/04/2008 |