Individual
LAUREN ASHLEY GRILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AU.D.
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 815-4969
(601) 984-5085
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 815-4969
(601) 984-5085
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
A0000001673
TN
231H00000X
Audiologist
Primary
A3938
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00207561
—
MS
Enumeration date
08/13/2013
Last updated
01/26/2017
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