Provider Demographics
NPI:1013526581
Name:EARL E. GRIFFITH, PH.D.
Entity Type:Organization
Organization Name:EARL E. GRIFFITH, PH.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EARL
Authorized Official - Middle Name:
Authorized Official - Last Name:GRIFFITH
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:772-283-4437
Mailing Address - Street 1:120 SW 6TH ST
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-2967
Mailing Address - Country:US
Mailing Address - Phone:772-283-4437
Mailing Address - Fax:
Practice Address - Street 1:120 SW 6TH ST
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-2967
Practice Address - Country:US
Practice Address - Phone:772-283-4437
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-30
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty