Provider Demographics
NPI:1548829930
Name:GRIFFETH, ALLISON (BCBA)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:GRIFFETH
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:603 DAVIS DR
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:GA
Mailing Address - Zip Code:30620-1703
Mailing Address - Country:US
Mailing Address - Phone:678-227-3591
Mailing Address - Fax:
Practice Address - Street 1:1215 HIGHTOWER TRL
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30350-6244
Practice Address - Country:US
Practice Address - Phone:866-750-5554
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-10
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1-19-35269103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst