Provider Demographics
NPI:1538903414
Name:GRIMNER, AMANDA (OTR/L, CBIS)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:GRIMNER
Suffix:
Gender:F
Credentials:OTR/L, CBIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 UNION ST
Mailing Address - Street 2:
Mailing Address - City:NATICK
Mailing Address - State:MA
Mailing Address - Zip Code:01760-6056
Mailing Address - Country:US
Mailing Address - Phone:508-433-4400
Mailing Address - Fax:
Practice Address - Street 1:310 BAKER AVE
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:MA
Practice Address - Zip Code:01742-2140
Practice Address - Country:US
Practice Address - Phone:978-287-8300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-24
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist