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General NPI Number Information
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NPI Number | 1629124813
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Entity Type | Individual
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Provider Name | MICHAEL ALLEN GRIFFITH PH.D.
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Gender | Male
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Dates
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Enumeration Date | 01/28/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 375 E HORSETOOTH RD SUITE 2-203
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City | FORT COLLINS
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State | CO
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Zip | 80525-3155
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Country | US
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Telephone | 970-204-6970
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Fax | 970-204-6985
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Provider Business Mailing Address
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Address Line | 375 E HORSETOOTH RD SUITE 2-203
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City | FORT COLLINS
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State | CO
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Zip | 80525-3155
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Country | US
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Telephone | 970-204-6970
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Fax | 970-204-6985
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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 | 2122
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License Number State | CO
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