Individual
MISS TYREIA LOUISE GRIMES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PRS
Contact information
Practice address
2180 ROMIG RD, AKRON, OH 44320-3879
(234) 334-3406
(234) 334-3456
Mailing address
326 GIRARD AVE NE, CANTON, OH 44704-2142
(234) 425-8911
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
175T00000X
Peer Specialist
Primary
APS.000528
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0490996
—
OH
Enumeration date
05/22/2018
Last updated
10/01/2024
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