Provider Demographics
NPI:1215550876
Name:GRIFFITHS, KYLETHIA T
Entity Type:Individual
Prefix:
First Name:KYLETHIA
Middle Name:T
Last Name:GRIFFITHS
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 1:9414 ROUGH SLATE CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89178-8225
Mailing Address - Country:US
Mailing Address - Phone:469-230-6839
Mailing Address - Fax:
Practice Address - Street 1:9414 ROUGH SLATE CT
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89178-8225
Practice Address - Country:US
Practice Address - Phone:469-230-6839
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-18
Last Update Date:2020-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health