Provider Demographics
NPI:1912204835
Name:GRIFFITH, ANNETTE KATHARINE (PHD, BCBA-D)
Entity Type:Individual
Prefix:DR
First Name:ANNETTE
Middle Name:KATHARINE
Last Name:GRIFFITH
Suffix:
Gender:F
Credentials:PHD, BCBA-D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:535 N COURT AVE
Mailing Address - Street 2:SUITE #15
Mailing Address - City:COLBY
Mailing Address - State:KS
Mailing Address - Zip Code:67701-2424
Mailing Address - Country:US
Mailing Address - Phone:785-626-2369
Mailing Address - Fax:
Practice Address - Street 1:535 N COURT AVE
Practice Address - Street 2:SUITE #15
Practice Address - City:COLBY
Practice Address - State:KS
Practice Address - Zip Code:67701-2424
Practice Address - Country:US
Practice Address - Phone:785-626-2369
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-13
Last Update Date:2015-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011003585103K00000X
320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities