Terra    Griffin    PHD
Contract Details
MindsMatter2
Facility name
Provider ID
P000009442
NPI
1982921763
Tax ID
272542090
Effective Date
10/18/2019
Last Updated
11/5/2019
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
500 Southland Drive
Hoover, AL 35226
United States
County
Jefferson
Phone
2052601014 (Phone)
Billing Details
Address
500 Southland Drive
Hoover, AL 35226
Billing Phone
2052601014
Specialty Type
Counselor - Professional
Map
Address