Healthcare Provider Details

I. General information

NPI: 1700716560
Provider Name (Legal Business Name): GRACE GRIFFIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 ELM SQ STE 317
ANDOVER MA
01810-3668
US

IV. Provider business mailing address

219 SAGAMORE AVE
PORTSMOUTH NH
03801-5526
US

V. Phone/Fax

Practice location:
  • Phone: 978-806-4781
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: