Provider Demographics
NPI:1518978774
Name:GROUSSMAN, BARBARA ANN (PHD)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:ANN
Last Name:GROUSSMAN
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 1:2325 COIT RD STE C
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-3795
Mailing Address - Country:US
Mailing Address - Phone:972-519-0093
Mailing Address - Fax:972-519-0093
Practice Address - Street 1:2325 COIT RD STE C
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-3795
Practice Address - Country:US
Practice Address - Phone:972-519-0093
Practice Address - Fax:972-519-0093
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX23343103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical