Individual
MICHELLE GRIMMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
405 E EXCELSIOR AVE, VINITA, OK 74301-4226
(918) 256-6476
(918) 256-3628
Mailing address
405 E EXCELSIOR AVE, VINITA, OK 74301-4226
(918) 256-6476
(918) 256-3628
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6565
OK
Other
Enumeration date
12/29/2015
Last updated
03/17/2018
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