Provider Demographics
NPI:1386974731
Name:GRIEFWORKS INC.
Entity type:Organization
Organization Name:GRIEFWORKS INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:THEODORA
Authorized Official - Middle Name:L
Authorized Official - Last Name:TARR
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:305-666-3650
Mailing Address - Street 1:9729 S DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156-2806
Mailing Address - Country:US
Mailing Address - Phone:305-666-3650
Mailing Address - Fax:305-666-1145
Practice Address - Street 1:9729 S DIXIE HWY
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33156-2806
Practice Address - Country:US
Practice Address - Phone:305-666-3650
Practice Address - Fax:305-666-1145
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-07
Last Update Date:2010-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY00005439103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty