Doctor Name: | MRS. NICOLA MARIE GRIMES |
NPI Number: | 1154646347 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS, CCC-SLP |
License Number: | KY1900 |
Business Practice Address: | 2420 W 3rd St Owensboro, KY - 423010328 |
Business Phone Number: | 2706853141 |
Business Fax Number: | 2706844867 |
Mailing Address: | 316 Morgan Ln, UTICA |
State: | KY |
Postal Code: | 423769062 |
Phone Number: | 2707333241 |
Fax Number: | |
NPI Enumeration Date: | 03/31/2010 |
NPI Last Update Date: | 03/31/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | KY1900 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KY |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |