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Individual

DALLAS GRASSBAUGH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2305 RENARD PL SE STE 110, ALBUQUERQUE, NM 87106-4258
(505) 518-1471
Mailing address
2305 RENARD PL SE STE 110, ALBUQUERQUE, NM 87106-4258

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
NM
171M00000X
Case Manager/Care Coordinator
Primary
NM

Other

Enumeration date
05/09/2018
Last updated
02/23/2026
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