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Individual

MRS. MAUREEN KELLY GRIFFIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.T.

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
16665
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
023348001
MD
01
16665
PT LICENSE
MD
01
382617193
CIGNA
MD
01
812314
EHP
MD
Enumeration date
03/01/2007
Last updated
01/18/2019
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