Individual
MISTY I. GRISALVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
800 EAST NINTH AVENUE, TURTH OR CONSEQUENCES, NM 87901
(575) 743-1205
Mailing address
800 EAST NINTH AVENUE, TURTH OR CONSEQUENCES, NM 87901
(575) 743-1205
(575) 874-7659
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
X-08765
NM
Other
Enumeration date
08/27/2014
Last updated
08/27/2014
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