Provider Demographics
NPI:1295222446
Name:GRIFFIN, TERESA
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:
Last Name:GRIFFIN
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 526
Mailing Address - Street 2:
Mailing Address - City:NORTH EASTON
Mailing Address - State:MA
Mailing Address - Zip Code:02356-0526
Mailing Address - Country:US
Mailing Address - Phone:617-750-5763
Mailing Address - Fax:508-433-1871
Practice Address - Street 1:535 S MAIN ST
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:MA
Practice Address - Zip Code:02368-5261
Practice Address - Country:US
Practice Address - Phone:617-750-5763
Practice Address - Fax:508-433-1871
Is Sole Proprietor?:No
Enumeration Date:2018-04-13
Last Update Date:2021-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health