Born-Grissom, Susannah

Born-Grissom, Susannah is an sole proprietor health care provider with primary practice located at 3915 Gramercy Ave , North Las Vegas NV 89031-2038. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Born-Grissom, Susannah can be contacted via phone (702) 628-2968.

Contact Information

Primary practice address
3915 Gramercy Ave North Las Vegas NV 89031-2038
Phone: (702) 628-2968
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X

Profile Details

NPI number 1730532441
LBN Legal business name Born-Grissom, Susannah
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 18th, 2016
Last updated Jul 18th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1730532441 NPPES
Nevada MEDICAID 123456789

Popular Providers