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Individual

DARA NATAKA ADESIMBO GRIMES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.ED

Contact information

Practice address
108 N FAYETTEVILLE ST, LIBERTY, NC 27298-3203
(336) 814-1731
Mailing address
6359 PATTERSON RD, SNOW CAMP, NC 27349-9015
(336) 814-1731

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
171M00000X
Case Manager/Care Coordinator
Primary
175T00000X
Peer Specialist

Other

Enumeration date
03/27/2023
Last updated
06/06/2023
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