Individual
MICHELLE GRIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED., SP
Contact information
Practice address
539 WINDSOR PARK DR, CENTERVILLE, OH 45459-4112
(937) 409-6156
Mailing address
539 WINDSOR PARK DR, CENTERVILLE, OH 45459-4112
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
SP.00638
OH
Other
Enumeration date
08/05/2016
Last updated
11/12/2018
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