Provider Demographics
NPI:1407417066
Name:GRIGGS-HOLKE, MIALAUNI (LMFT)
Entity type:Individual
Prefix:
First Name:MIALAUNI
Middle Name:
Last Name:GRIGGS-HOLKE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:MIALAUNI
Other - Middle Name:
Other - Last Name:GRIGGS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT
Mailing Address - Street 1:7030 INDIANAPOLIS BLVD
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:IN
Mailing Address - Zip Code:46324-2208
Mailing Address - Country:US
Mailing Address - Phone:773-726-7497
Mailing Address - Fax:
Practice Address - Street 1:7030 INDIANAPOLIS BLVD
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:IN
Practice Address - Zip Code:46324-2208
Practice Address - Country:US
Practice Address - Phone:773-726-7497
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-25
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN35002248A106H00000X
IL166.001562106H00000X
106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty