Raven Grimm
Behavior Technician in North Fort Myers, FL. Individual provider (NPI-1).
NPI number1710691456
StatusActive
Last updated in NPPESJan 9, 2023
Details
- NPI
- 1710691456
- Entity type
- Individual (NPI-1)
- Name
- Raven Grimm
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jan 9, 2023
- Certification date
- Jan 8, 2023
- Last updated
- Jan 9, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | 792697 | FL | Yes |
Practice location
4085 Hancock Bridge Pkwy Ste 101North Fort Myers, FL 33903-7220
Phone 239-677-3767
Mailing address
300 International PkwyLake Mary, FL 32746-5035
Phone 866-610-3625
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All 136 Behavior Technician providers in North Fort Myers · All 472 providers in North Fort Myers
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