Individual
MS. BRENDA MAE GRISSOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
3014 ERIE AVE, SHEBOYGAN, WI 53081-3658
(920) 459-3028
(920) 459-4341
Mailing address
5764 COUNTY ROAD Q, COLGATE, WI 53017-9717
(262) 573-6130
(262) 573-6130
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
4870-026
WI
Other
Enumeration date
11/09/2010
Last updated
10/31/2022
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