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Individual

SHATARI GRIMES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
59 EXECUTIVE PARK S, ATLANTA, GA 30329-2208
(678) 551-8213
Mailing address
5915 CRESCENT RIDGE CT, LITHONIA, GA 30058-8370

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
09509
MD
225X00000X
Occupational Therapist
OT007367
GA

Other

Enumeration date
08/05/2019
Last updated
10/14/2022
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