Grisham Associates Ltd | |
8910 Main St Woodstock GA 30188-4916 | |
(770) 924-1818 | |
(770) 928-5731 |
Full Name | Grisham Associates Ltd |
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Speciality | Psychologist |
Location | 8910 Main St, Woodstock, Georgia |
Authorized Official Name and Position | Milton Grisham (PSYCHOLOGIST) |
Authorized Official Contact | 7709241818 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Grisham Associates Ltd 3642 Childers Way Ne Roswell GA 30075-5275 Ph: () - | Grisham Associates Ltd 8910 Main St Woodstock GA 30188-4916 Ph: (770) 924-1818 |
NPI Number | 1639295405 |
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Provider Enumeration Date | 03/22/2007 |
Last Update Date | 08/22/2020 |
Medicare PECOS PAC ID | 2163597964 |
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Medicare Enrollment ID | O20080813000418 |
Identifier | Type | State | Issuer |
---|---|---|---|
1639295405 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103T00000X | Psychologist | 1336 (Georgia) | Primary |
Provider Name | Milton S Grisham |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1235255019 PECOS PAC ID: 2567537350 Enrollment ID: I20080813000380 |
Provider Name | Joanna Grisham |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1427277441 PECOS PAC ID: 9032531165 Enrollment ID: I20200623001727 |
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