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Individual

DR. KELLY MARIE GRIM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AU.D

Contact information

Practice address
125 BALDWIN AVE, SUITE 100, CHARLOTTE, NC 28204-3370
(704) 316-1900
(704) 316-1932
Mailing address
PO BOX 601529, CHARLOTTE, NC 28260-1529
(704) 316-1900

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
10637
NC
235Z00000X
Speech-Language Pathologist
10637
NC

Other

Enumeration date
11/01/2007
Last updated
09/16/2014
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