Provider Demographics
NPI:1255112199
Name:RICHARDS, GRIFFIN LOUISA
Entity type:Individual
Prefix:
First Name:GRIFFIN
Middle Name:LOUISA
Last Name:RICHARDS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2019
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:WY
Mailing Address - Zip Code:83001-2019
Mailing Address - Country:US
Mailing Address - Phone:307-690-3180
Mailing Address - Fax:
Practice Address - Street 1:125 E PEARL AVE STE B005
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:WY
Practice Address - Zip Code:83001-8599
Practice Address - Country:US
Practice Address - Phone:307-690-3180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-06
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor