Provider Demographics
NPI:1033842760
Name:GRIMSLEY, CATHY L
Entity Type:Individual
Prefix:
First Name:CATHY
Middle Name:L
Last Name:GRIMSLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4805 E DIXON ST
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85205-6456
Mailing Address - Country:US
Mailing Address - Phone:480-217-1550
Mailing Address - Fax:
Practice Address - Street 1:1255 W BASELINE RD STE 138
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85202-5821
Practice Address - Country:US
Practice Address - Phone:480-820-5422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-09
Last Update Date:2022-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XM0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistMental Health