Provider Demographics
NPI:1891846465
Name:GRIFFITH, CONSTANCE CAPPAS (PHD)
Entity Type:Individual
Prefix:
First Name:CONSTANCE
Middle Name:CAPPAS
Last Name:GRIFFITH
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:CONSTANCE
Other - Middle Name:LYNNE
Other - Last Name:CAPPAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:375 E HORSETOOTH RD
Mailing Address - Street 2:BUILDING 2-203
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-3155
Mailing Address - Country:US
Mailing Address - Phone:970-204-1126
Mailing Address - Fax:970-204-6985
Practice Address - Street 1:375 E HORSETOOTH RD
Practice Address - Street 2:BUILDING 2-203
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-3155
Practice Address - Country:US
Practice Address - Phone:970-204-1126
Practice Address - Fax:970-204-6985
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2079103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical