Provider Demographics
NPI:1841513876
Name:GRIMM, TAMARA LOUISE (LISW)
Entity type:Individual
Prefix:MS
First Name:TAMARA
Middle Name:LOUISE
Last Name:GRIMM
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11500 NORTHLAKE DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45249-1650
Mailing Address - Country:US
Mailing Address - Phone:513-247-4280
Mailing Address - Fax:513-247-4648
Practice Address - Street 1:3200 VINE ST
Practice Address - Street 2:WOMEN'S HEALTH DEPT
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45220-2213
Practice Address - Country:US
Practice Address - Phone:513-247-4280
Practice Address - Fax:513-247-4648
Is Sole Proprietor?:No
Enumeration Date:2010-03-04
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.08003151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical