Provider Demographics
NPI:1083275267
Name:GRIGGS, COURTNEY D (BCBA)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:D
Last Name:GRIGGS
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:433 FOUNTAINHEAD CIR UNIT 185
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-3280
Mailing Address - Country:US
Mailing Address - Phone:334-492-2036
Mailing Address - Fax:
Practice Address - Street 1:900 W MAGNOLIA ST FL 34741
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-4117
Practice Address - Country:US
Practice Address - Phone:844-331-6451
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-27
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-22-59266103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst