Individual
LEEANNA MARIE GRONDIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
243 COOK AVE, RATON, NM 87740-3930
(580) 319-5770
(580) 319-7086
Mailing address
PO BOX 796, RATON, NM 87740-0796
(580) 319-5770
(580) 319-7086
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-24-372396
NM
Other
Enumeration date
08/26/2024
Last updated
08/26/2024
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