Provider Demographics
NPI:1073646790
Name:GRIFFIN, STEPHANIE RUTH (MS LMFT)
Entity Type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:RUTH
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:MS LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1349 LAMAR AVENUE
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:TX
Mailing Address - Zip Code:75460
Mailing Address - Country:US
Mailing Address - Phone:903-784-6493
Mailing Address - Fax:903-784-3780
Practice Address - Street 1:1349 LAMAR AVENUE
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TX
Practice Address - Zip Code:75460
Practice Address - Country:US
Practice Address - Phone:903-784-6493
Practice Address - Fax:903-784-3780
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX002634106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist