Provider Information for 1609849405
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Mr. DAVID Y GRIMM L.M.F.T.
Sex: Male
NPI: 1609849405
Last Updated: 2007-07-08
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1609849405 | ||||||||
| Enumeration Date | 2006-02-10 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 1555 HOWELL BRANCH RD SUITE B-4 WINTER PARK, FL 32789-1109 United States Phone: 407-644-2121 | Fax:407-644-2974 | ||||||||
| Primary Practice Address | 1555 HOWELL BRANCH RD SUITE B-4 WINTER PARK, FL 32789-1109 United States Phone: 407-644-2121 | Fax:407-644-2974 | ||||||||
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