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Individual

LATONIA S GRISSOM-BLUE (POLLARD)

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMSW- CLINICAL

Contact information

Practice address
1105 PURDUE AVE, CLOVIS, NM 88101-5342
(806) 598-1114
Mailing address
1105 PURDUE AVE, CLOVIS, NM 88101-5342

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
M-08035
NM
1041C0700X
Clinical Social Worker
Primary
6801119307
MI
1041S0200X
School Social Worker
M-08035
NM

Other

Enumeration date
09/26/2012
Last updated
05/11/2026
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