Provider Demographics
NPI:1326132556
Name:GRIMMETT, DOROTHY KAYE
Entity Type:Individual
Prefix:MRS
First Name:DOROTHY
Middle Name:KAYE
Last Name:GRIMMETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KAYE
Other - Middle Name:PASKETT
Other - Last Name:GRIMMETT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:843 MAR JANE AVE
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84107
Mailing Address - Country:US
Mailing Address - Phone:801-268-3080
Mailing Address - Fax:801-268-3080
Practice Address - Street 1:843 MAR JANE AVE
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107
Practice Address - Country:US
Practice Address - Phone:801-268-3080
Practice Address - Fax:801-268-3080
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT17346935011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical