Provider Demographics
NPI:1245598226
Name:GRIFFITH, NOVA MARIE (PHD)
Entity Type:Individual
Prefix:DR
First Name:NOVA
Middle Name:MARIE
Last Name:GRIFFITH
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:515 1/2 E BROADWAY AVE
Mailing Address - Street 2:SUITE 106
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58501-4408
Mailing Address - Country:US
Mailing Address - Phone:701-751-0443
Mailing Address - Fax:701-751-1616
Practice Address - Street 1:515 1/2 E BROADWAY AVE
Practice Address - Street 2:SUITE 106
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58501-4408
Practice Address - Country:US
Practice Address - Phone:701-751-0443
Practice Address - Fax:701-751-1616
Is Sole Proprietor?:No
Enumeration Date:2012-04-27
Last Update Date:2014-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071.007669103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical