Gina T Grimes, Ed.S., CCC-SLP
Speech-Language Pathologist, in Valdosta, GA. Individual provider (NPI-1).
NPI number1982103420
StatusActive
Last updated in NPPESFeb 11, 2018
Details
- NPI
- 1982103420
- Entity type
- Individual (NPI-1)
- Name
- Gina T Grimes
- Credential
- Ed.S., CCC-SLP
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Feb 11, 2018
- Last updated
- Feb 11, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 235Z00000X | Speech-Language Pathologist, | SLP004334 | GA | Yes |
Practice location
3825 Johnston RdValdosta, GA 31601-2113
Phone 229-460-0943
Mailing address
3825 Johnston RdValdosta, GA 31601-2113
Phone 229-460-0943
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