| Grambling Therapy Inc | |
|
4686 Corrales Rd Corrales NM 87048-8610 | |
| (505) 266-7693 | |
| (505) 890-4223 |
| Full Name | Grambling Therapy Inc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 4686 Corrales Rd, Corrales, New Mexico |
| Authorized Official Name and Position | Gail Grambling Harrison (PRESIDENT) |
| Authorized Official Contact | 5052667693 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Grambling Therapy Inc 4686 Corrales Rd Corrales NM 87048-8610 Ph: (505) 266-7693 | Grambling Therapy Inc 4686 Corrales Rd Corrales NM 87048-8610 Ph: (505) 266-7693 |
| NPI Number | 1285770198 |
|---|---|
| Provider Enumeration Date | 01/29/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285770198 | NPI | - | NPPES |
| 000B8044 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 0642 (New Mexico) | Primary |
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