Provider Demographics
NPI:1336576271
Name:GRIZZLE, LINDSEY (BCBA)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:
Last Name:GRIZZLE
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:370 W. SIERRA MADRE BLVD.
Mailing Address - Street 2:SUITE B
Mailing Address - City:SIERRA MADRE
Mailing Address - State:CA
Mailing Address - Zip Code:91024
Mailing Address - Country:US
Mailing Address - Phone:626-355-5160
Mailing Address - Fax:626-355-5173
Practice Address - Street 1:370 W. SIERRA MADRE BLVD.
Practice Address - Street 2:SUITE B
Practice Address - City:SIERRA MADRE
Practice Address - State:CA
Practice Address - Zip Code:91024
Practice Address - Country:US
Practice Address - Phone:626-355-5160
Practice Address - Fax:626-355-5173
Is Sole Proprietor?:No
Enumeration Date:2013-10-10
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-13-13916103K00000X
CA1-13-13916103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst