Individual
MICHELE LYNN GRIMM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1200 S CLINTON ST, FORT WAYNE, IN 46802-3504
(260) 467-1150
(260) 467-1188
Mailing address
1200 BARR ST, FORT WAYNE, IN 46802-3502
(260) 710-1275
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
1079963
IN
Other
Enumeration date
09/30/2024
Last updated
09/30/2024
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