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Individual

KATHRYN GRIMES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1711 S NEIL ST STE 2, CHAMPAIGN, IL 61820-7262
(872) 256-8818
Mailing address
2816 N 1100 EAST RD, MANSFIELD, IL 61854-6857
(815) 383-7461

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
150104071
IL

Other

Enumeration date
11/24/2019
Last updated
04/18/2025
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