Provider Demographics
NPI:1083803936
Name:GRIFFEN, PATRICIA LILLIAN (PHD)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:LILLIAN
Last Name:GRIFFEN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 CORPORATE HILL DR
Mailing Address - Street 2:SUITE 205
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-4549
Mailing Address - Country:US
Mailing Address - Phone:501-223-8883
Mailing Address - Fax:
Practice Address - Street 1:18 CORPORATE HILL DR
Practice Address - Street 2:SUITE 205
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-4549
Practice Address - Country:US
Practice Address - Phone:501-223-8883
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-17
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAR79-6P103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR56174Medicare PIN