Individual
KLARISSA GRISSOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14800 JOPLIN RD, MANASSAS, VA 20112-3909
(703) 791-8081
Mailing address
4025 HUFFINES BLVD APT 2205, CARROLLTON, TX 75010-6560
(314) 914-2211
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
119604
TX
235Z00000X
Speech-Language Pathologist
Primary
2204001085
VA
Other
Enumeration date
12/15/2022
Last updated
03/15/2023
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