Organization
MIMIGRIMM MA INDIVIDUAL, COUPLE, & FAMILY THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIANN ELIZABETH GRIMM MA (MARRIAGE AND FAMILY THERAPIST)
(727) 504-4126
Entity
Organization
Contact information
Practice address
685 MAIN ST, SUITE C, SAFETY HARBOR, FL 34695-3562
(727) 504-4126
(727) 216-3998
Mailing address
860 CAMBRIDGE CT, DUNEDIN, FL 34698-6101
(727) 504-4126
(727) 216-3998
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
2514MT
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
779438
—
FL
Enumeration date
02/09/2015
Last updated
02/09/2015
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