Individual
SOTDERIA GRIFFIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
124 KIMBROUGH BLVD BLDG Q, TALLULAH, LA 71282-4307
(318) 574-4400
(318) 574-4407
Mailing address
879 WILLIAM BLVD APT 21C, RIDGELAND, MS 39157-1571
(601) 310-6900
(318) 574-4407
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
5886
LA
Other
Enumeration date
06/14/2016
Last updated
06/14/2016
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