MEDICARE: CHRISTINE GRIFFIS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1568706315
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINE GRIFFIS

Provider Business Mailing Address
First Line	:	4803 WOODLAND AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19143-4433
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4803 WOODLAND AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19143-4433
Country	:	US
Telephone Number	:	215-326-9491
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/18/2012
Last Update Date	:	11/18/2012

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Directions to “ CHRISTINE GRIFFIS ” Practice Location

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