Individual
DR. LEE ANN GRISOLANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
500 UNIVERSITY DR, HERSHEY, PA 17033-2360
(717) 531-8414
(717) 531-0276
Mailing address
PO BOX 858, MC A410, HERSHEY, PA 17033-0858
(800) 243-1455
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PS009003L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0017941350004
—
PA
Enumeration date
09/13/2005
Last updated
04/10/2019
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