Healthcare Provider Details

I. General information

NPI: 1336159276
Provider Name (Legal Business Name): JAMES J GRIFFIN PSY.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2006
Last Update Date: 12/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3550 COUNTY HOME RD 120
TODDVILLE IA
52341-9726
US

IV. Provider business mailing address

3550 COUNTY HOME RD 120
TODDVILLE IA
52341-9726
US

V. Phone/Fax

Practice location:
  • Phone: 319-393-6796
  • Fax: 319-378-8621
Mailing address:
  • Phone: 319-393-6796
  • Fax: 319-378-8621

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number00807
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number00337
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: