Grayson, Revonda Lynn
Grayson, Revonda Lynn is an individual health care provider with primary practice located at 2200 Bergquist Dr Ste 1 , Lackland A F B TX 78236-9908. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical Neuropsychologist, which is considered as her primary health care specialty. Grayson, Revonda Lynn can be contacted via phone (210) 292-7722.Contact Information
Primary practice address
2200 Bergquist Dr Ste 1
Lackland A F B TX 78236-9908
Phone: (210) 292-7722
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical Neuropsychologist | 103G00000X | 0810002986 | Virginia |
Profile Details
| NPI number | 1093893059 |
|---|---|
| LBN Legal business name | Grayson, Revonda Lynn |
| Credentials | PH.D. |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 1st, 2006 |
| Last updated | Jul 8th, 2007 - about 18 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.
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