Individual
MS. PAMELA JANE GRASSBAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC., LADAC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
0117671
NM
101YP2500X
Professional Counselor
Primary
0145801
NM
101YP2500X
Professional Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
18677037
—
NM
05
—
54788854
—
NM
Enumeration date
10/06/2006
Last updated
04/02/2014
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