# THE GRIFFIN PROMISE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083037956
- **Authorized official:** LORI FREDERICK (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (918) 893-3735

## Contact information

- **Practice address:** 3100 S ELM PL STE A, BROKEN ARROW, OK 74012-7950
- **Practice address phone:** (918) 893-3735
- **Practice address fax:** (918) 893-3745
- **Mailing address:** 3100 S ELM PL STE A, BROKEN ARROW, OK 74012-7950
- **Mailing address phone:** (918) 893-3735
- **Mailing address fax:** (918) 893-3745

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YP2500X | Professional Counselor | — | NULL | — |
| 101YP2500X | Professional Counselor | — | — | — |
| 2080P0008X | Pediatric Neurodevelopmental Disabilities Physician | — | NULL | — |
| 2080P0008X | Pediatric Neurodevelopmental Disabilities Physician | — | — | — |
| 235Z00000X | Speech-Language Pathologist | 2767 | OK | Yes |

## Other

- **Enumeration date:** 01/29/2014
- **Last updated:** 09/26/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 200536910A | — | OK |