# MIMIGRIMM,MA,INDIVIDUAL,COUPLE&FAMILY THERAPY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1689041618
- **Authorized official:** MARIANN ELIZABETH GRIMM MA (MARRIAGE AND FAMILY THERAPIST)
- **Authorized official phone:** (727) 504-4126

## Contact information

- **Practice address:** 132 10TH AVE N, 103 D, SAFETY HARBOR, FL 34695-3407
- **Practice address phone:** (727) 504-4126
- **Practice address fax:** (727) 216-3998
- **Mailing address:** 860 CAMBRIDGE CT, DUNEDIN, FL 34698-6101
- **Mailing address phone:** (727) 504-4126
- **Mailing address fax:** (727) 216-3998

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | MT2514 | FL | Yes |

## Other

- **Enumeration date:** 08/25/2015
- **Last updated:** 08/25/2015