Individual
ROBERT GRELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LISW
Contact information
Practice address
5312 JAGUAR DR, SANTA FE, NM 87507-1827
(505) 820-0262
(505) 820-9220
Mailing address
5312 JAGUAR DR, SANTA FE, NM 87507-1827
(505) 820-0262
(505) 820-9220
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
073791
NY
1041C0700X
Clinical Social Worker
Primary
I 05661
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
97720321
—
NM
Enumeration date
09/27/2006
Last updated
07/08/2007
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