Individual
HAILEY PARKER GRIMES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1140 AMERICAN LEGION BLVD, MOUNTAIN HOME, ID 83647-2821
(208) 580-5431
Mailing address
7113B DUNES LOOP, MOUNTAIN HOME AFB, ID 83648-4800
(256) 872-3057
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
4471546
ID
Other
Enumeration date
01/29/2025
Last updated
01/29/2025
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