Individual
JADIE GAIL MALARK GRIMM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
3960 COON RAPIDS BLVD NW STE 123, COON RAPIDS, MN 55433-2521
(763) 236-7337
Mailing address
8020 PARELL AVE NE, OTSEGO, MN 55330-4562
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
528701
MN
235Z00000X
Speech-Language Pathologist
SP-2653
NV
235Z00000X
Speech-Language Pathologist
SP-2858
NV
Other
Enumeration date
12/08/2019
Last updated
09/17/2023
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