Individual
MS. DIANA MIZELL GRIGSBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SPEECH PATHOLOGIST
Contact information
Practice address
3220 CANAL ST, RUSTON, LA 71270-6678
(318) 548-5963
Mailing address
3220 CANAL ST, RUSTON, LA 71270-6678
(318) 548-5963
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
795
LA
Other
Enumeration date
10/29/2019
Last updated
10/29/2019
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