Individual
GRADY WALKER JARAMILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
104 DES GEORGE LN, TAOS, NM 87571
(575) 770-6476
Mailing address
PO BOX 985, EL PRADO, NM 87529-0985
(575) 770-6476
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
171M00000X
Case Manager/Care Coordinator
CTB-2023-0448
NM
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
12/22/2021
Last updated
10/31/2025
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