Individual
LILLIE MICHELLE GRIMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D
Contact information
Practice address
642 S ALASKA ST STE 220, PALMER, AK 99645-6378
(907) 331-0220
(855) 702-2532
Mailing address
6450 E VERBONCOEUR DR, WASILLA, AK 99654-4550
(907) 715-8175
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
142607
AK
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/15/2014
Last updated
07/09/2021
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