Doctor Name: | MRS. LATONYA HARRIS GRIMES |
NPI Number: | 1508143512 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MSW, LCSW |
License Number: | C007386 |
Business Practice Address: | 642 Broadmoor Ct Grimesland, NC - 278379188 |
Business Phone Number: | 2529160784 |
Business Fax Number: | 2527586681 |
Mailing Address: | Po Box 375, SIMPSON |
State: | NC |
Postal Code: | 278790375 |
Phone Number: | 2529160784 |
Fax Number: | 2527586681 |
NPI Enumeration Date: | 11/05/2011 |
NPI Last Update Date: | 11/05/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | C007386 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |