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Organization

GROTTO PSYCHOLOGICAL SOLUTIONS, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MELISSA M SISCO PHD (OWNER/PSYCHOLOGIST)
(704) 292-6020
Entity
Organization

Contact information

Practice address
3612 CREEKSIDE DR, GASTONIA, NC 28056-7118
(704) 292-6020
Mailing address
3612 CREEKSIDE DR, GASTONIA, NC 28056-7118
(704) 292-6020

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5744
NC BOARD OF PSYCHOLOGY CERTIFICATION
NC
Enumeration date
07/15/2022
Last updated
07/15/2022
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