Provider Demographics
NPI:1285233098
Name:GRIFFITH, HOLLY
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:
Last Name:GRIFFITH
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 1:12097 PINE ST
Mailing Address - Street 2:
Mailing Address - City:FELTON
Mailing Address - State:PA
Mailing Address - Zip Code:17322-8403
Mailing Address - Country:US
Mailing Address - Phone:717-825-9658
Mailing Address - Fax:
Practice Address - Street 1:509 QUINCE ORCHARD ROAD
Practice Address - Street 2:SUITE 205
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20878
Practice Address - Country:US
Practice Address - Phone:855-832-6727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-22
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARBT-20-137746106S00000X
MDLBA2073103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician