Individual
MRS. DONNA S. GRISHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
553 PORTLAND COBALT RD, PORTLAND, CT 06480-1968
(860) 342-0760
(860) 342-4226
Mailing address
553 PORTLAND COBALT RD, PORTLAND, CT 06480-1968
(860) 342-0760
(860) 342-4226
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
000424
CT
Other
Enumeration date
06/03/2006
Last updated
07/14/2011
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