Individual
LISA E GRINNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPCC
Contact information
Practice address
3824 TUNDRA SWAN CT NW, ALBUQUERQUE, NM 87120-4110
(575) 313-2964
Mailing address
3824 TUNDRA SWAN CT NW, ALBUQUERQUE, NM 87120-4110
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0123791
NM
Other
Enumeration date
11/14/2009
Last updated
11/14/2009
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