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General NPI Number Information
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NPI Number | 1578172235
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Entity Type | Individual
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Provider Name | LATIERJA GRIFFIN MS
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Gender | Female
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Dates
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Enumeration Date | 07/29/2020
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Last Update Date | 07/29/2020
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Provider Practice Location Address
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Address Line | 1332 BROADWAY ST
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City | PEARLAND
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State | TX
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Zip | 77581-6306
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Country | US
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Telephone | 951-902-5630
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Fax |
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Provider Business Mailing Address
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Address Line | 6301 PALE SAGE DR APT 5304
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City | HOUSTON
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State | TX
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Zip | 77049-2161
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Country | US
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Telephone | 951-902-5630
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 12042389
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License Number State | CA
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