Provider Demographics
NPI:1285449959
Name:GRIFFIN, BRYONNE
Entity type:Individual
Prefix:
First Name:BRYONNE
Middle Name:
Last Name:GRIFFIN
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 1:6910 ITHACA HEIGHTS LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-2320
Mailing Address - Country:US
Mailing Address - Phone:530-809-7174
Mailing Address - Fax:
Practice Address - Street 1:40352 BLOSSOM VALLEY LN
Practice Address - Street 2:
Practice Address - City:MAGNOLIA
Practice Address - State:TX
Practice Address - Zip Code:77354-4563
Practice Address - Country:US
Practice Address - Phone:832-610-4372
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-10
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician