Provider Demographics
NPI:1184726010
Name:ROLLISON, DEBORAH GRINDROD (STUDENT/INTERN)
Entity type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:GRINDROD
Last Name:ROLLISON
Suffix:
Gender:F
Credentials:STUDENT/INTERN
Other - Prefix:MISS
Other - First Name:DEBORAH
Other - Middle Name:ANN
Other - Last Name:MARSHALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1232 WINDMILL LN
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20905-6054
Mailing Address - Country:US
Mailing Address - Phone:301-879-2721
Mailing Address - Fax:
Practice Address - Street 1:1620 ELTON RD
Practice Address - Street 2:SUITE 204
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20903-1740
Practice Address - Country:US
Practice Address - Phone:301-439-7191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral