Individual
STACY GRIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
604 HIGHWAY 80 W, CLINTON, MS 39056-4108
(601) 473-2106
Mailing address
669 NEW HOPE RD, MOUNT OLIVE, MS 39119-5639
(479) 208-3513
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
05/09/2022
Last updated
05/09/2022
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