Individual
ANDREA GRIMM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
1120 N NEW RD, WACO, TX 76710-4860
(254) 776-1704
Mailing address
500 FRANKLIN AVE, WACO, TX 76701-2111
(254) 755-9569
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
15164
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0658338-01
—
TX
Enumeration date
12/17/2021
Last updated
12/17/2021
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