Provider Demographics
NPI:1578842126
Name:GRIFFITH, LINDA LOU
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:LOU
Last Name:GRIFFITH
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 1:10498 FOUNTAIN LAKE DR APT 1424
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77477-3768
Mailing Address - Country:US
Mailing Address - Phone:832-563-2602
Mailing Address - Fax:281-302-0214
Practice Address - Street 1:10498 FOUNTAIN LAKE DR APT 1424
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:TX
Practice Address - Zip Code:77477-3768
Practice Address - Country:US
Practice Address - Phone:832-563-2602
Practice Address - Fax:281-302-0214
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-15
Last Update Date:2011-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX38471104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker