Provider Demographics
NPI:1407993892
Name:GRELLO, CATHERINE M (PHD)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:M
Last Name:GRELLO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 WESTFIELD DR
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-4824
Mailing Address - Country:US
Mailing Address - Phone:865-584-8547
Mailing Address - Fax:865-584-5932
Practice Address - Street 1:305 WESTFIELD DR
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-4824
Practice Address - Country:US
Practice Address - Phone:865-584-8547
Practice Address - Fax:865-584-5932
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2686103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical