Individual
MISS MARISSA MILDRED GRABOWY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LEP
Contact information
Practice address
3899 HAINES ST BLDG 8, SAN DIEGO, CA 92109-6354
(858) 775-2654
(858) 246-6874
Mailing address
3899 HAINES ST BLDG 8, SAN DIEGO, CA 92109-6354
(858) 775-2654
(858) 246-6874
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
3128
CA
103TB0200X
Cognitive & Behavioral Psychologist
3128
CA
103TC1900X
Counseling Psychologist
3128
CA
103TM1800X
Intellectual & Developmental Disabilities Psychologist
Primary
3128
CA
103TM1800X
Intellectual & Developmental Disabilities Psychologist
—
—
103TS0200X
School Psychologist
3128
CA
Other
Enumeration date
07/27/2010
Last updated
07/27/2010
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