Provider Demographics
NPI:1164852356
Name:GRINDROD, DEVIN MICHELLE
Entity Type:Individual
Prefix:MISS
First Name:DEVIN
Middle Name:MICHELLE
Last Name:GRINDROD
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 1:1633 DIAMOND ST
Mailing Address - Street 2:APT. # 32
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92109-3159
Mailing Address - Country:US
Mailing Address - Phone:914-213-0613
Mailing Address - Fax:
Practice Address - Street 1:2535 KETTNER BLVD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92101-1250
Practice Address - Country:US
Practice Address - Phone:619-615-0701
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-25
Last Update Date:2013-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor