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NPI 1386080646

NPI 1386080646 : DANIEL MICHAEL GRIFFIN PHD : TAKOMA PARK, MD

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General NPI Number Information
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    NPI Number           |    1386080646
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    Entity Type          |    Individual 
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    Provider Name        |    DANIEL MICHAEL GRIFFIN PHD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    05/14/2013
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    Last Update Date     |    05/14/2013
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Provider Practice Location Address
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    Address Line         |    500 PHILADELPHIA AVE 
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    City                 |    TAKOMA PARK
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    State                |    MD
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    Zip                  |    20912-4147
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    Country              |    US
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    Telephone            |    301-495-4848
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    500 PHILADELPHIA AVE 
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    City                 |    TAKOMA PARK
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    State                |    MD
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    Zip                  |    20912-4147
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    Country              |    US
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    Telephone            |    301-495-4848
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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        |    103T00000X
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    Taxonomy Name        |    Psychologist
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    License Number       |    03751
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    License Number State |    MD
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