Individual
SAMANTHA MARIE GRIMES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
720 ESKENAZI AVE, INDIANAPOLIS, IN 46202-5187
(317) 880-8484
Mailing address
4901 CARROLLTON AVE, INDIANAPOLIS, IN 46205-1125
(765) 714-9179
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
39003215A
IN
Other
Enumeration date
02/25/2018
Last updated
11/23/2021
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