Provider Demographics
NPI:1457371726
Name:GRIMES, HELEN DENISE (PHD)
Entity Type:Individual
Prefix:
First Name:HELEN
Middle Name:DENISE
Last Name:GRIMES
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 W ALAMEDA AVE
Mailing Address - Street 2:STE 103
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91502-2571
Mailing Address - Country:US
Mailing Address - Phone:818-842-6459
Mailing Address - Fax:
Practice Address - Street 1:213 W ALAMEDA AVE
Practice Address - Street 2:STE 103
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91502-2571
Practice Address - Country:US
Practice Address - Phone:818-842-6459
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMN014661106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist