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1326479080
SUSAN GRISSOM
LINO LAKES, MN
NPI
1326479080
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
235Z00000X Speech-Language Pathologist,
(Licence: MN 251272)
Enumeration Date
2013-12-06
Last Update Date
2013-12-06
Business Address
-- SUSAN GRISSOM
6776 LAKE DRIVE ADVANCE THERAPY
LINO LAKES, MN 55014
Phone number: 651-498-2071
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Mailing Address
-- SUSAN GRISSOM
13585 ELKWOOD DR
APPLE VALLEY, MN 55124-5232
Phone number: 952-451-4575
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