Individual
DR. MAUREEN O'KANE GRISSOM
Active
Individual
DR. MAUREEN O'KANE GRISSOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
2006034116
MO
103T00000X
Psychologist
2006034116
MO
103T00000X
Psychologist
38769
TX
103TC0700X
Clinical Psychologist
Primary
38769
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2006034116
MO LICENSE
MO
01
—
38769
TEXAS STATE LICENSE
TX
Enumeration date
08/09/2007
Last updated
08/31/2022
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