Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225400000X | Rehabilitation Practitioner | ||
N | 225C00000X | Rehabilitation Counselor |
NPI | 1285926451 |
---|---|
Provider Name | Jennifer Grimes-Vawters |
First Address | Reno, NV 89502-7117 |
Second Address | Reno, NV 89502-7117 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/05/2011 |
Last Update Date | 06/05/2011 |