Individual
MS. GAYLA KAY GRISHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LBSW
Contact information
Practice address
421 VILLA DRIVE #209, WACO, TX 76710
(254) 405-2702
(866) 686-9651
Mailing address
421 VILLA DRIVE #209, WACO, TX 76710
(254) 405-2702
(866) 686-9651
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
33966
TX
171M00000X
Case Manager/Care Coordinator
Primary
33966
TX
251B00000X
Case Management Agency
33966
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
182404701
—
TX
05
—
182405401
—
TX
Enumeration date
03/08/2007
Last updated
07/20/2007
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