Provider Demographics
NPI:1376987040
Name:GRIFFIN, GINGER LEE (EDS)
Entity Type:Individual
Prefix:MRS
First Name:GINGER
Middle Name:LEE
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212B HOLLY HILL DR
Mailing Address - Street 2:
Mailing Address - City:BRIDGEWATER
Mailing Address - State:VA
Mailing Address - Zip Code:22812-1036
Mailing Address - Country:US
Mailing Address - Phone:540-280-6995
Mailing Address - Fax:
Practice Address - Street 1:601 UNIVERSITY BLVD - MSC 9011
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22807
Practice Address - Country:US
Practice Address - Phone:540-568-6687
Practice Address - Fax:540-568-3875
Is Sole Proprietor?:No
Enumeration Date:2013-04-24
Last Update Date:2013-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0803000217103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool