Provider Demographics
NPI:1245581040
Name:PRIEUR, MARY GRIMLEY (PHD)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:GRIMLEY
Last Name:PRIEUR
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CB # 7160
Mailing Address - Street 2:DEPARTMENT OF PSYCHIATRY, UNC SCHOOL OF MEDICINE
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27599-7160
Mailing Address - Country:US
Mailing Address - Phone:919-843-3209
Mailing Address - Fax:919-843-6102
Practice Address - Street 1:CB # 7160
Practice Address - Street 2:DEPARTMENT OF PSYCHIATRY, UNC SCHOOL OF MEDICINE
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-7160
Practice Address - Country:US
Practice Address - Phone:919-843-3209
Practice Address - Fax:919-843-6102
Is Sole Proprietor?:No
Enumeration Date:2012-09-20
Last Update Date:2014-11-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC102990103TC0700X, 103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent