Individual
MRS. STEPHANIE FAWBUSH GRIMES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, LD
Contact information
Practice address
1411 E BRECKINRIDGE ST, LOUISVILLE, KY 40204-1707
(859) 814-3306
Mailing address
1411 E BRECKINRIDGE ST, LOUISVILLE, KY 40204-1707
(859) 814-3306
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86056577
—
Other
Enumeration date
09/19/2023
Last updated
09/19/2023
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