Provider Demographics
NPI:1649486275
Name:GRIMES, JANE ELIZABETH-LINDSAY (OTR)
Entity type:Individual
Prefix:MS
First Name:JANE
Middle Name:ELIZABETH-LINDSAY
Last Name:GRIMES
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:697 WOODCREEK CIR
Mailing Address - Street 2:
Mailing Address - City:SALINE
Mailing Address - State:MI
Mailing Address - Zip Code:48176-1178
Mailing Address - Country:US
Mailing Address - Phone:313-408-5490
Mailing Address - Fax:
Practice Address - Street 1:5840 INTERFACE DR STE 400
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-9176
Practice Address - Country:US
Practice Address - Phone:734-627-8001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201007141225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist