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Individual

JACKIE GRIMMETT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PSYCHOLOGIST

Contact information

Practice address
PO BOX 63255, COLORADO SPRINGS, CO 80962-3255
(719) 641-5131
Mailing address
PO BOX 63255, COLORADO SPRINGS, CO 80962-3255
(719) 641-5131

Taxonomy

Speciality
Code
Description
License number
State
103TF0200X
Forensic Psychologist
35736
CA
103TF0200X
Forensic Psychologist
Primary
3938
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
202504035
TAX ID
CO
Enumeration date
08/30/2006
Last updated
10/16/2025
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