Provider Demographics
NPI:1740734276
Name:GRIFFIN, WENDY LEIGH (LCSW)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:LEIGH
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:LEIGH
Other - Last Name:GRIFFIN-HILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:728 FLORAL DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-4208
Mailing Address - Country:US
Mailing Address - Phone:321-512-4368
Mailing Address - Fax:
Practice Address - Street 1:728 FLORAL DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-4208
Practice Address - Country:US
Practice Address - Phone:321-512-4368
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-13
Last Update Date:2016-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW60391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical