Individual
MALLORY THERESE GRIMM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED, BCBA, COBA
Contact information
Practice address
6005 LANDERHAVEN DR STE B1, MAYFIELD HEIGHTS, OH 44124-4042
(216) 343-1198
Mailing address
6005 LANDERHAVEN DR STE B1, MAYFIELD HEIGHTS, OH 44124-4042
(216) 343-1198
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
COBA.01005.
OH
Other
Enumeration date
04/06/2022
Last updated
04/06/2022
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