Provider Demographics
NPI:1194177873
Name:GRIGGS, BAYLEE
Entity Type:Individual
Prefix:
First Name:BAYLEE
Middle Name:
Last Name:GRIGGS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7296 N LAVAL AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-0334
Mailing Address - Country:US
Mailing Address - Phone:559-474-0831
Mailing Address - Fax:
Practice Address - Street 1:117 N R ST
Practice Address - Street 2:
Practice Address - City:MADERA
Practice Address - State:CA
Practice Address - Zip Code:93637-4465
Practice Address - Country:US
Practice Address - Phone:559-662-0527
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-06
Last Update Date:2016-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist