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DR. MAUREEN O'KANE GRISSOM PH.D.

Clinical Neuropsychologist

Columbia, Missouri

Provider NPI: 1144411513

Provider Information:
DR. MAUREEN O'KANE GRISSOM PH.D.
Gender: F
Not Sole Proprietor

Practice Location:
THOMPSON CENTER 300 PORTLAND ST., SUITE, 110 COLUMBIA, MO 65211 US
Tel: 573-884-5352  Fax: --

Business Mailing Address:
THOMPSON CENTER 300 PORTLAND ST., SUITE, 110 COLUMBIA, MO 65211 US
Tel: --  Fax: --

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
MO2006034116
N103T00000XBehavioral Health & Social Service Providers
Psychologist
MO2006034116

Other Provider Identifiers:

IssuerNumberStateType
MO LICENSE2006034116MO01
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







CLINICAL NEUROPSYCHOLOGIST JOBS MO - Page 1



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