Provider Demographics
NPI:1457089146
Name:GRIM, BRITTA (COTA)
Entity Type:Individual
Prefix:
First Name:BRITTA
Middle Name:
Last Name:GRIM
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5406 VELD CT
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22407-8731
Mailing Address - Country:US
Mailing Address - Phone:540-460-6138
Mailing Address - Fax:
Practice Address - Street 1:14115 LOVERS LN STE 115
Practice Address - Street 2:
Practice Address - City:CULPEPER
Practice Address - State:VA
Practice Address - Zip Code:22701-4158
Practice Address - Country:US
Practice Address - Phone:540-225-1150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-10
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant