Provider Information for 1770047797
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AURILIA GRAY-GRIMES LMHC
Other Names:Other Name:AURILIA GRIMESSex: Female
NPI: 1770047797
Last Updated: 2022-10-05
Certification Date: 2022-10-05
Certification Date: 2022-10-05
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1770047797 | ||||||||||||
| Enumeration Date | 2019-01-23 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 2551 NW 103RD AVE APT 109 SUNRISE, FL 33322-6805 United States Phone: 754-249-6359 | Fax: | ||||||||||||
| Primary Practice Address | 2551 NW 103RD AVE APT 109 SUNRISE, FL 33322-6805 United States Phone: 754-249-6359 | Fax: | ||||||||||||
| Secondary Practice Address(es) | 3911 HOLLYWOOD BLVD | ||||||||||||
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