Provider Demographics
NPI:1356950042
Name:GRIFFIN, CHIOMA ADAKU
Entity type:Individual
Prefix:
First Name:CHIOMA
Middle Name:ADAKU
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 1:101 W TENNESSEE AVE
Mailing Address - Street 2:
Mailing Address - City:CREWE
Mailing Address - State:VA
Mailing Address - Zip Code:23930-1821
Mailing Address - Country:US
Mailing Address - Phone:804-362-7161
Mailing Address - Fax:
Practice Address - Street 1:101 W TENNESSEE AVE
Practice Address - Street 2:
Practice Address - City:CREWE
Practice Address - State:VA
Practice Address - Zip Code:23930-1821
Practice Address - Country:US
Practice Address - Phone:804-362-7161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-28
Last Update Date:2020-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0734002983101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health