Individual
SANDI KISER GRIFFITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LIC PSYCHOLOGIST
Contact information
Practice address
748 BEECH ST, KENORA, WV 25530
(304) 453-2433
Mailing address
748 BEECH ST, KENORA, WV 25530
(304) 453-2433
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
727
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0165152000
—
WV
Enumeration date
12/04/2006
Last updated
07/08/2007
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