Individual
MRS. MARY B GRIMMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
601 W MICHIGAN ST, ORLANDO, FL 32805-6203
(407) 317-7430
(407) 540-1925
Mailing address
3873 OLD DUNN RD, APOPKA, FL 32712-4788
(407) 814-9433
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
1041C0700X
Clinical Social Worker
SW 8196
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7680899
—
FL
05
—
8117527 00
—
FL
Enumeration date
11/14/2006
Last updated
04/15/2012
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