Provider Demographics
NPI:1144390709
Name:GIFFEN, DEVORAH AVIVA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:DEVORAH
Middle Name:AVIVA
Last Name:GIFFEN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5069
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31414-5069
Mailing Address - Country:US
Mailing Address - Phone:912-231-1080
Mailing Address - Fax:912-231-1046
Practice Address - Street 1:2216 SKIDAWAY RD
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31404-3820
Practice Address - Country:US
Practice Address - Phone:912-231-1080
Practice Address - Fax:912-231-1046
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY001764103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical