MEDICARE: ASHA MONIQUE GRIFFITH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor
2	101YM0800X	Mental Health Counselor	MH16804	FL

General Provider Information

NPI Number	:	1699106633
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHA MONIQUE GRIFFITH

Provider Business Mailing Address
First Line	:	15501 BRUCE B DOWNS BLVD APT 1506
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33647-1307
Country	:	US
Telephone Number	:	347-797-8147
Fax Number	:

Provider Business Practice Location Address
First Line	:	15501 BRUCE B DOWNS BLVD APT 1506
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33647-1307
Country	:	US
Telephone Number	:	347-797-8147
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/02/2013
Last Update Date	:	10/08/2019

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