Jack Holland Grisham, PH.D.

Psychologist · Marietta, GA

Individual Active NPI

NPI number 1376692061

Practice location

122 Cherry St NE
Marietta, GA 30060-7206
Phone
(770) 427-2911
Fax
(770) 422-2302

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NPI record

NPI
1376692061
Entity type
Individual (Type 1)
Enumeration date
January 10, 2007
Last updated
July 8, 2007
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Psychologist Primary 103T00000X 000669 GA

About Dr. Grisham

Jack Holland Grisham, PH.D. is a healthcare provider registered in the NPI registry with the primary taxonomy Psychologist (code 103T00000X). The practice location is 122 Cherry St NE, Marietta, GA 30060-7206. The NPI number 1376692061 was assigned on January 10, 2007 and the record was last updated on July 8, 2007.

Dr. Grisham lists a license in the registry: #000669 (GA) for Psychologist. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Jack Holland Grisham, PH.D.?

The NPI number is 1376692061.

What is the phone number of Dr. Grisham?

The phone number listed for the practice location is (770) 427-2911.

Where is Dr. Grisham located?

122 Cherry St NE, Marietta, GA 30060-7206.

What is the taxonomy code for Dr. Grisham?

The primary taxonomy code is 103T00000X – Psychologist.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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