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Individual
WILSON TYLER GRIMMETT
Active
Individual
WILSON TYLER GRIMMETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
01/16/2018
Last updated
08/05/2024
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