Grimes, Susan Loraine

Grimes, Susan Loraine is an individual health care provider with primary practice located at 5601 Bridge St Suite 401, Fort Worth TX 76112-2384. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapy Assistant, which is considered as her primary health care specialty. Grimes, Susan Loraine can be contacted via phone (817) 446-5000.

Contact Information

Primary practice address
5601 Bridge St Suite 401 Fort Worth TX 76112-2384
Phone: (817) 446-5000
Fax: (817) 332-7801
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapy Assistant 224Z00000X 207832 Texas

Profile Details

NPI number 1639363799
LBN Legal business name Grimes, Susan Loraine
Credentials Certified Occupational Therapy Assistant (COTA)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 31st, 2007
Last updated Feb 28th, 2011 - about 14 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 1639363799 NPPES
Texas Other 207832 LICENSE

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