| Erica R. Griffin Llc | |
|
561 Poole Melton Rd Blythe GA 30805-3813 | |
| (773) 954-5022 | |
| Not Available |
| Full Name | Erica R. Griffin Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 561 Poole Melton Rd, Blythe, Georgia |
| Authorized Official Name and Position | Erica R Griffin (OWNER) |
| Authorized Official Contact | 7739545022 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Erica R. Griffin Llc 561 Poole Melton Rd Blythe GA 30805-3813 Ph: (773) 954-5022 | Erica R. Griffin Llc 561 Poole Melton Rd Blythe GA 30805-3813 Ph: (773) 954-5022 |
| NPI Number | 1356717797 |
|---|---|
| Provider Enumeration Date | 08/20/2015 |
| Last Update Date | 08/20/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356717797 | NPI | - | NPPES |
| 003144054A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | LPC007543 (Georgia) | Primary |