Provider Demographics
NPI:1306408851
Name:DILLON, GRINASHA MARIE
Entity Type:Individual
Prefix:
First Name:GRINASHA
Middle Name:MARIE
Last Name:DILLON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4000 BIENVILLE ST STE G
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70119-5163
Mailing Address - Country:US
Mailing Address - Phone:504-266-4849
Mailing Address - Fax:504-988-0301
Practice Address - Street 1:4000 BIENVILLE ST STE G
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-5163
Practice Address - Country:US
Practice Address - Phone:504-988-0301
Practice Address - Fax:504-988-0302
Is Sole Proprietor?:No
Enumeration Date:2019-07-05
Last Update Date:2019-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator