Provider Demographics
NPI:1760132237
Name:GRIFFIN, DAVID K (EDD, BCBA-D)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:K
Last Name:GRIFFIN
Suffix:
Gender:M
Credentials:EDD, BCBA-D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10921 NW 7TH CT
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-8108
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3301 COLLEGE AVE
Practice Address - Street 2:DESANTIS 4140
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33314
Practice Address - Country:US
Practice Address - Phone:954-770-9461
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-27
Last Update Date:2022-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSS725103TS0200X
103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool