Individual
DR. JAYNE A. GRANDISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ED.D., HSPP
Contact information
Practice address
7009 W AUGUSTA BLVD, YORKTOWN, IN 47396-9330
(765) 759-6160
(765) 759-6160
Mailing address
7009 W AUGUSTA BLVD, YORKTOWN, IN 47396-9330
(765) 759-6160
(765) 759-6160
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
IN#20040030
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000179367
ANTHEM BC/BS
IN
01
—
2046272
CIGNA
IN
Enumeration date
07/05/2005
Last updated
11/18/2007
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