Provider Demographics
NPI:1194454835
Name:GRIFFIN, KYLAA
Entity Type:Individual
Prefix:
First Name:KYLAA
Middle Name:
Last Name:GRIFFIN
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 1:6363 RICHMOND AVE STE 508
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057-6129
Mailing Address - Country:US
Mailing Address - Phone:832-669-9926
Mailing Address - Fax:832-669-9984
Practice Address - Street 1:6363 RICHMOND AVE STE 508
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-6129
Practice Address - Country:US
Practice Address - Phone:832-669-9926
Practice Address - Fax:832-669-9984
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-08
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No172V00000XOther Service ProvidersCommunity Health Worker