Provider Demographics
NPI:1639577356
Name:GRIFFIN-MALITI, ZHAWANTAE (PHD)
Entity Type:Individual
Prefix:DR
First Name:ZHAWANTAE
Middle Name:
Last Name:GRIFFIN-MALITI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14673 MIDWAY RD STE 213
Mailing Address - Street 2:
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001-3952
Mailing Address - Country:US
Mailing Address - Phone:512-508-8874
Mailing Address - Fax:469-221-9160
Practice Address - Street 1:14673 MIDWAY RD STE 213
Practice Address - Street 2:
Practice Address - City:ADDISON
Practice Address - State:TX
Practice Address - Zip Code:75001-3952
Practice Address - Country:US
Practice Address - Phone:512-508-8874
Practice Address - Fax:469-221-9160
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-11
Last Update Date:2014-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist