Individual
JEFFREY SCOTT GRIMES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
5625 BROADWAY ST, SAN ANTONIO, TX 78209-5719
(210) 621-3462
(210) 822-7466
Mailing address
5625 BROADWAY ST, SAN ANTONIO, TX 78209-5719
(210) 621-3462
(210) 822-7466
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
33564
TX
Other
Enumeration date
10/23/2007
Last updated
09/30/2009
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