MEDICARE: CHRISTOPHER GRIFFIN

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	103TC1900X	Counseling Psychologist

General Provider Information

NPI Number	:	1912700188
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER GRIFFIN

Provider Business Mailing Address
First Line	:	10729 N 19TH AVE
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85029-4921
Country	:	US
Telephone Number	:	702-267-8034
Fax Number	:

Provider Business Practice Location Address
First Line	:	10729 N 19TH AVE
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85029-4921
Country	:	US
Telephone Number	:	702-267-8034
Fax Number	:

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

Provider Enumeration Date	:	03/31/2025
Last Update Date	:	03/31/2025

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