Individual
KATHRYN GRISSOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
95 MAIN STREET, SUITE 2, EAST HAMPTON, CT 06424
(860) 440-7288
Mailing address
PO BOX 4039, NEW HAVEN, CT 06525
(661) 972-5707
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
09/07/2020
Last updated
09/07/2020
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