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Individual

CAUDIE R GRISSOM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
2616 OLD WESLEY CHAPEL RD, SUITE 207, DECATUR, GA 30034-2367
(404) 408-1253
(404) 289-8055
Mailing address
2616 OLD WESLEY CHAPEL RD, SUITE 207, DECATUR, GA 30034-2367
(404) 408-1253
(404) 289-8055

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
010853725
GA

Other

Enumeration date
01/26/2010
Last updated
01/26/2010
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