MEDICARE: DR. SARAH (SALLY) BUCHANAN GRIMLEY PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	1007	NC

General Provider Information

NPI Number	:	1154309979
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SARAH (SALLY) BUCHANAN GRIMLEY PH.D.

Provider Business Mailing Address
First Line	:	883 WASHINGTON ST
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27605-3251
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	883 WASHINGTON ST
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27605-3251
Country	:	US
Telephone Number	:	919-832-2991
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/03/2006
Last Update Date	:	07/08/2007

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