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Organization

YMG PSYCHOLOGICAL SERVICES, PLLC

Active
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Organization

YMG PSYCHOLOGICAL SERVICES, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DYNESHA D MASON GRISSOM PHD, LCP, MSCP (OWNER/PSYCHOLOGIST)
(217) 278-0159
Entity
Organization

Contact information

Practice address
701 DEVONSHIRE DR. BLD. C SUITE 132, CHAMPAIGN, IL 61820
(217) 278-0159
Mailing address
306 W GRAHAM DR, SAVOY, IL 61874-9441
(217) 278-0159

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary

Other

Enumeration date
11/22/2022
Last updated
11/22/2022
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