Provider Demographics
NPI:1518286038
Name:GRIFFIN, DOROTHY JEAN (MED, LPC)
Entity Type:Individual
Prefix:
First Name:DOROTHY
Middle Name:JEAN
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:136 TOM MARSH RD
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77351-0809
Mailing Address - Country:US
Mailing Address - Phone:936-645-7538
Mailing Address - Fax:
Practice Address - Street 1:123 CR 4260 (HWY 69 SOUTH @ SENECA)
Practice Address - Street 2:
Practice Address - City:WOODVILLE
Practice Address - State:TX
Practice Address - Zip Code:75979
Practice Address - Country:US
Practice Address - Phone:409-283-2130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-24
Last Update Date:2010-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX61937101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional