Individual
SARAH GRENZEBACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
24 POLVADERA PL, YOUNGSVILLE, NM 87064-0199
(617) 834-8204
Mailing address
PO BOX 817, ABIQUIU, NM 87510-0817
(617) 834-8204
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CCMH0223711
NM
101YM0800X
Mental Health Counselor
CMH0200251
NM
Other
Enumeration date
05/15/2019
Last updated
02/15/2023
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