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General NPI Number Information
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NPI Number | 1245574110
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Entity Type | Individual
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Provider Name | JEANA RENEE' GRIFFITH PH.D.
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Gender | Female
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Dates
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Enumeration Date | 11/16/2012
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Last Update Date | 01/06/2025
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Provider Practice Location Address
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Address Line | 1291 BIG WATER CIR
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City | GREENSBORO
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State | GA
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Zip | 30642-3715
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Country | US
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Telephone | 770-771-6330
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Fax |
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Provider Business Mailing Address
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Address Line | 6350 LAKE OCONEE PKWY #110 PMB 56
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City | GREENSBORO
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State | GA
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Zip | 30642
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Country | US
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Telephone | 770-771-6330
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 002334
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License Number State | GA
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