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Organization
GRAY WOLF COUNSELING, INC.
Active
Organization
GRAY WOLF COUNSELING, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT HOWARD MEDDAUGH MS,MFT,LADC, CPGC (OWNER - THERAPIST)
(505) 506-1877
Entity
Organization
Contact information
Practice address
854 MISSION VALLEY RD, CORRALES, NM 87048-7829
(505) 506-1877
Mailing address
854 MISSION VALLEY RD, CORRALES, NM 87048-7829
(505) 506-1877
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
0125
NV
101YA0400X
Addiction (Substance Use Disorder) Counselor
0162551
NM
106H00000X
Marriage & Family Therapist
Primary
0145071
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
033514011
NM CRS
NM
Enumeration date
05/20/2016
Last updated
05/20/2016
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