Individual
CC GRIFFIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3481 E SUNSET RD, LAS VEGAS, NV 89120-3228
(657) 444-9002
Mailing address
3481 E SUNSET RD, LAS VEGAS, NV 89120-3228
(657) 444-9002
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-20-121541
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00002606316
—
NV
Enumeration date
06/12/2020
Last updated
06/12/2020
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