Individual
NICOLE LYNN GRIFFITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
133 N MAIN ST, CENTERVILLE, OH 45459-4620
(937) 433-3931
Mailing address
133 N MAIN ST, CENTERVILLE, OH 45459-4620
(937) 433-3931
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1891226262
—
OH
Enumeration date
02/11/2019
Last updated
02/11/2019
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