Grimes, Destinie T

Grimes, Destinie T is an sole proprietor health care provider with primary practice located at 43520 Division St , Lancaster CA 93535-4089. She recently has only one registered license in Behavioral Health & Social Service Providers / Counselor, which is considered as her primary health care specialty. Grimes, Destinie T can be contacted via phone (661) 266-4783.

Contact Information

Primary practice address
43520 Division St Lancaster CA 93535-4089
Fax: (661) 266-1210
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X

Profile Details

NPI number 1821382920
LBN Legal business name Grimes, Destinie T
Credentials MSA
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 6th, 2011
Last updated Jun 6th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1821382920 NPPES
California Other 95-2633765 MEDI-CAL

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