Individual
BRUCE GROSSMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPCC
Contact information
Practice address
631 KIT CARSON RD, TAOS, NM 87571-6452
(505) 758-7835
(505) 758-7835
Mailing address
631 KIT CARSON RD, TAOS, NM 87571-6452
(505) 758-7835
(505) 758-7835
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
190
NM
Other
Enumeration date
08/09/2006
Last updated
07/08/2007
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