Provider Demographics
NPI:1033898424
Name:GRIFFITH, AUBREY B (MACC)
Entity Type:Individual
Prefix:
First Name:AUBREY
Middle Name:B
Last Name:GRIFFITH
Suffix:
Gender:F
Credentials:MACC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 PARK VILLAGE LN
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27455-2464
Mailing Address - Country:US
Mailing Address - Phone:336-880-8988
Mailing Address - Fax:
Practice Address - Street 1:70 PARK VILLAGE LN
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27455-2464
Practice Address - Country:US
Practice Address - Phone:336-880-8988
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-13
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA18967101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health