Provider Demographics
NPI:1255504809
Name:GRIFFITH-HENRY, KYNA D (PHD)
Entity type:Individual
Prefix:
First Name:KYNA
Middle Name:D
Last Name:GRIFFITH-HENRY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 KYLE DR
Mailing Address - Street 2:
Mailing Address - City:PHILLIPSBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08865-7313
Mailing Address - Country:US
Mailing Address - Phone:908-878-9353
Mailing Address - Fax:
Practice Address - Street 1:403 COVENTRY DR
Practice Address - Street 2:
Practice Address - City:PHILLIPSBURG
Practice Address - State:NJ
Practice Address - Zip Code:08865-1969
Practice Address - Country:US
Practice Address - Phone:908-386-2100
Practice Address - Fax:908-386-2200
Is Sole Proprietor?:No
Enumeration Date:2008-04-03
Last Update Date:2020-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS016405103TC0700X
NJ35SI00614400103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical