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Individual

DR. GRETCHEN ANN MIMS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMSW, PH.D

Contact information

Practice address
81 BOLTON TRL, NORTH CHILI, NY 14514-9774
(585) 889-6429
Mailing address
81 BOLTON TRL, NORTH CHILI, NY 14514-9774
(585) 889-6429

Taxonomy

Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
072120-1
NY

Other

Enumeration date
10/26/2011
Last updated
10/26/2011
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