Provider Demographics
NPI:1912788860
Name:GRIFFIN, LAURA (LPC-A)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:LPC-A
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 593198
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78259-0209
Mailing Address - Country:US
Mailing Address - Phone:210-757-3150
Mailing Address - Fax:800-508-0086
Practice Address - Street 1:19115 FM 2252 STE 4
Practice Address - Street 2:
Practice Address - City:GARDEN RIDGE
Practice Address - State:TX
Practice Address - Zip Code:78266-2578
Practice Address - Country:US
Practice Address - Phone:210-757-3150
Practice Address - Fax:800-508-0086
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-06
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty