Provider Demographics
NPI:1538662291
Name:MCGRIFF, CANDI CALVINA
Entity Type:Individual
Prefix:
First Name:CANDI
Middle Name:CALVINA
Last Name:MCGRIFF
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 1:4223 NE 9TH ST
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33033-5579
Mailing Address - Country:US
Mailing Address - Phone:305-956-6867
Mailing Address - Fax:
Practice Address - Street 1:4223 NE 9TH ST
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33033-5579
Practice Address - Country:US
Practice Address - Phone:305-956-6867
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-08
Last Update Date:2018-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician