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Individual

BRANDI JO GRIMES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
QASP-S

Contact information

Practice address
69 LINDSEY LN STE B, SAINT MARYS, GA 31558-1702
(912) 266-8686
Mailing address
103 JOHANSEN WAY, KINGSLAND, GA 31548-6857

Taxonomy

Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
11513
GA
106S00000X
Behavior Technician
RBT-20-110101

Other

Enumeration date
06/03/2020
Last updated
05/02/2022
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