Provider Demographics
NPI:1447985965
Name:GRIFFITH, KYLER JAY (MA)
Entity type:Individual
Prefix:
First Name:KYLER
Middle Name:JAY
Last Name:GRIFFITH
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3187 S FOREST AVE
Mailing Address - Street 2:
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:UT
Mailing Address - Zip Code:84045-4927
Mailing Address - Country:US
Mailing Address - Phone:801-889-5932
Mailing Address - Fax:
Practice Address - Street 1:1305 N COMMERCE DR STE 100
Practice Address - Street 2:
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:UT
Practice Address - Zip Code:84045-5307
Practice Address - Country:US
Practice Address - Phone:801-341-8274
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-19
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT12884766-6009101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health