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General NPI Number Information
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NPI Number | 1558067157
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Entity Type | Individual
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Provider Name | HEATHER AUBREY GRINDLE MT-BC, NMT
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Gender | Female
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Dates
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Enumeration Date | 02/06/2023
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Last Update Date | 10/20/2025
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Provider Practice Location Address
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Address Line | 2107 GUNN HWY STE 106
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City | ODESSA
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State | FL
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Zip | 33556-3513
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Country | US
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Telephone | 571-224-7314
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Fax |
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Provider Business Mailing Address
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Address Line | 621 MCCAWLEY ST
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City | OCEANSIDE
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State | CA
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Zip | 92058-8366
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225A00000X
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Taxonomy Name | Music Therapist
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License Number |
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License Number State |
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