Individual
MIRANDA CLARA GRIMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
105 RUNNING DEER DR, LAFAYETTE, LA 70503-6602
(318) 359-8994
Mailing address
105 RUNNING DEER DR, LAFAYETTE, LA 70503-6602
(318) 359-8994
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
329834
LA
Other
Enumeration date
05/29/2022
Last updated
05/29/2022
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