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NPI Code Detail

MEDICARE: KRISTIN NICOLE GRIFFIS MA, BCBA, LBA

MEDICARE:   KRISTIN NICOLE GRIFFIS  MA, BCBA, LBA
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
1106S00000XBehavior TechnicianRBT-19-88542
2103K00000XBehavior Analyst288239KY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1RBT-19-88542OTHERRBT CERTIFICATE
21-23-68212OTHERKYBACB

General Provider Information

NPI Number : 1619538675
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTIN NICOLE GRIFFIS MA, BCBA, LBA
Provider Business Mailing Address
First Line : 109 WIND HAVEN DR
Second Line :
City : NICHOLASVILLE
State : KY
Zip : 40356-8010
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 799 E BRANNON RD
Second Line :
City : NICHOLASVILLE
State : KY
Zip : 40356-6038
Country : US
Telephone Number : 606-280-5187
Fax Number : 859-224-4675
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2019
Last Update Date : 10/04/2023

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Directions to “ KRISTIN NICOLE GRIFFIS MA, BCBA, LBA” Practice Location

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