Provider Demographics
NPI:1962399535
Name:GRIFFITH, REBECCA LYNNMARIE
Entity type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:LYNNMARIE
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 1:111 WEAVER DAM RD
Mailing Address - Street 2:
Mailing Address - City:PETERSBURG
Mailing Address - State:NY
Mailing Address - Zip Code:12138-5220
Mailing Address - Country:US
Mailing Address - Phone:518-330-9383
Mailing Address - Fax:
Practice Address - Street 1:111 WEAVER DAM RD
Practice Address - Street 2:
Practice Address - City:PETERSBURG
Practice Address - State:NY
Practice Address - Zip Code:12138-5220
Practice Address - Country:US
Practice Address - Phone:518-330-9383
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-18
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)