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General NPI Number Information
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NPI Number | 1770047797
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Entity Type | Individual
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Provider Name | AURILIA GRAY-GRIMES LMHC
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Gender | Female
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Dates
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Enumeration Date | 01/23/2019
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Last Update Date | 10/05/2022
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Provider Practice Location Address
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Address Line | 2551 NW 103RD AVE APT 109
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City | SUNRISE
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State | FL
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Zip | 33322-6805
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Country | US
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Telephone | 754-249-6359
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Fax |
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Provider Business Mailing Address
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Address Line | 2551 NW 103RD AVE APT 109
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City | SUNRISE
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State | FL
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Zip | 33322-6805
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Country | US
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Telephone | 754-249-6359
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | IMH17344
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH18368
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License Number State | FL
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